N A N NY CO N T RACT

This is a n a g r e e m e n t ("Ag r e e m e n t") b e t w e e n N I COL E’S NA N NI ES, LLC,

("t h e Ag e n cy"), a n d __________________________ ("N a n ny"), fo r r ef e r r al a n d
a s si s t a n c e in pl a c e m e n t a s a c hild-c a r e p r of e s sio n al. In c o n si d e r a tio n of t h e
m u t u al p r o mi s e s c o n t ai n e d in t hi s Agr e e m e n t, N a n n y a n d t h e Ag e n cy a g r e e
a s follo w s:

N ICOLE’S NA N N I ES, LLC (t h e “AGE N CY”) is a N a n n y r ef e r r al s e r vic e t h a t

s c r e e n s a n d r ef e r s c hil d c a r e p r of e s sio n al s (“ NA N NY”) t o p e r s o n s s e e ki n g
s u c h s e rvic e s (“CLIE NT”). N a n n y h a s c o n t a c t e d t h e Ag e n cy s e e ki n g
a s si s t a n c e in job pl a c e m e n t a s a N a n ny wit h a CLIE NT. This
NA N NY/AGE N CY Ag r e e m e n t is eff e c tiv e a s of t h e d a t e t hi s Ag r e e m e n t is
s u b mi t t e d.

TER M S A N D CO N D ITIO N S
a. Th e AGE N CY is s ol ely a N a n n y r ef e r r al a g e n cy. T h e AGE N CY h a s n o
e m ploy m e n t r el a tio n s hi p wi t h a n y N a n n y o r a n y CLIE NT.

b. Th e AGE N CY h a s n o c o n t r ol ov e r o r involv e m e n t wi t h t h e
c o m p e n s a tio n, b e n efit s, d u ti e s, h o u r s, o r r e s p o n si biliti e s of a ny NA N NY.

c. Th e CLIE NT t h a t c h o o s e s t o e m ploy a n y NA N NY s h all h a v e c o m pl e t e

c o n t r ol ov e r all s u c h n e g o ti a tio n s, a s w ell a s a ny o t h e r m a t t e r involvin g
e m ploy m e n t of t h e NA N NY.

b. CLIE NT o r NA N NY s h all b e r e s p o n si bl e fo r c o m pli a n c e wit h all

a p plic a bl e la w s r el a ti n g t o e m ploy m e n t of a NA N NY, incl u di n g, b u t n o t
li mit e d t o, p a y m e n t of all a p plic a bl e p a y r oll t ax e s, S o ci al S e c u ri ty, o r
M e di c a r e a s s e s s m e n t s , a n d F e d e r al o r S t a t e wi t h h ol di n g o r
u n e m ploy m e n t t ax e s a ri si n g a s a r e s ul t of e m ploy m e n t of a n y NA N NY by
CLIE NT.

c. NA N NY a g r e e s t o k e e p all t h e info r m a tio n giv e n t o NA N NY a b o u t t h e

CLIE NTs c o nfi d e n ti al.

I N D E M N I FICATIO N
a. NA N NY s h all in d e m nify a n d h ol d t h e AGE N CY, it s m e m b e r s ,
m a n a g e r s, di r e c t o r s, offic e r s, e m pl oy e e s, s u c c e s s o r s, o r a s si g n s, h a r ml e s s
fro m a n d a g ai n s t a n y a n d all s ui t s, a c tio n s, los s e s, d a m a g e s, cl ai m s, o r
lia bility of a n y c h a r a c t er, ty p e , o r d e s c ri p tio n, in cl u di n g wi t h o u t li mit a tio n,
all e x p e n s e s of litig a tio n, c o u r t c o s t s, a n d a t t o r n e y’s fe e s, fo r inj u ry o r
d e a t h t o a ny p e r s o n, o r inju ry t o a ny p r o p e r ty, r e c eiv e d o r s u s t ai n e d by
a ny p e r s o n o r p e r s o n s o r p r o p e r ty, all e g e d by t h e CLIE NT, t h e NA N NY,
t h e CLIE NT’s fa mily o r a n y t hi r d p a r ty, in cl u di n g a c t s of o mis sio n o r
c o m m i s sio n o n t h e p a r t of t h e N a n ny, CLIE NT o r CLIE NT’s fa mily, a n d
 incl u di n g cl ai m s a n d d a m a g e s a ri si n g in w h ol e o r in p a r t fro m t h e
n e gli g e n c e of t h e AGE N CY.

b. NA N NY r el e a s e s a n d di s c h a r g e s t h e AGE N CY, it s m e m b e r s ,
m a n a g e r s, di r e c t o r s, offic e r s, e m pl oy e e s, s u c c e s s o r s, a n d a s si g n s fro m
a ny a n d all p ay m e n t s, cl ai m s, d e m a n d s, d e b t s , a c c o u n t s, ju d g m e n t s,
g ri ev a n c e s , a c tio n s, c a u s e s of a c tio n, c o n t ri b u tio n s, in d e m ni ti e s, los s e s,
d a m a g e s , e x p e n s e s , c o s t s, p r of e s sio n al fe e s (in cl u di n g, b u t n o t li mit e d t o,
a t t o r n e y s’ fe e s) a n d lia biliti e s of a n y ki n d, n a t u r e a n d d e s c ri p tio n
w h a t s o ev er, n o w a c c r u e d o r w hi c h m a y h e r e af t e r a c c r u e (“Cl ai m s”)
r el a ti n g t o o r a ri si n g o u t of t h e p e rfo r m a n c e o r n o n p e rfo r m a n c e of t his.
c. NA N NY a c k n o wl e d g e s a n d a g r e e s t h a t t h e for e g oi n g r el e a s e of
Cl ai m s is in t e n d e d t o b e a full a n d fin al s e t tl e m e n t a n d r el e a s e of all
Cl ai m s t h a t m a y a ri s e fro m t h e p e rfo r m a n c e o r n o n p e rfo r m a n c e of t hi s
Ag r e e m e n t b u t t h e AGE N CY, in cl u di n g, b u t n o t li mi t e d t o, t h e Ag e n cy’s
r ef e r r al s e rvic e s .

I c e r t i fy t h a t t h e a n s w e r s a n d i n f o r m a t i o n g i v e n i n t h e N a n n y
A p p l i c a t i o n ( s u b m i t t e d p ri o r t o t h i s A g r e e m e n t ) a r e f a c t u a l , t r u e a n d
c o m pl et ed to th e b e st of my knowled g e. I u nd erstand that
fal sifi c ati o n s, o m i s si o n s, or m i sr e pr e s e n t ati o n s m ay b e c a u s e for
r ej e c t i o n o f m y a p p l i c a t i o n b y t h e A g e n c y a n d / o r a n y o f i t s Cli e n t s .

I a u t h oriz e t h e i nv e s ti g a ti o n of all i nf or m a ti o n c o n t ai n e d in t hi s
a p p l i c a t i o n a s i s d e e m e d n e c e s s a ry. I f u r t h e r a u t h o r i z e a n y e m p l o y er,
p e r s o n , c o r p o r a t i o n , e d u c a t i o n a l i n s t i t u t i o n , o r a n y o t h e r e n t i ty
li s t e d w i t h i n , i n c l u d i n g t h e A g e n cy, t o a n s w e r a n y a n d a l l q u e s t i o n s
r e g ardi n g m e a n d m y i nf or m a ti o n a s it relat e s t o N a n ny s ervic e s a n d
a g r e e t o h o l d a l l p e r s o n s h a r m l e s s f o r p r o vi d i n g a n y a n d a l l
i nf or m a ti o n wit hi n t h e ir k n o wl e d g e or r e c ord s.

B y s i g n i n g b e l ow , I f u l ly u n d e r s t a n d a n d a c c e p t a l l o f t h e a b o v e
t e r m s a n d c o n d i t i o n s a s t h e y a r e s t a t e d i n t h i s A g r e e m e n t . Fail u r e t o
d o s o c a n r e s u l t i n i m m e d i a t e d i s m i s s a l fr o m u s i n g t h e s e r v i c e s o f
t h e A g e n cy.

DATE: _________________, 2 0_______

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