Contingent Worker Consent Form

Recitals
A. The Contingent Worker (the Worker) is engaged by an entity (the Supplier) which provides
temporary and contracted workers under the GGS0060 Temporary and Contracted Workers
Preferred Supplier Panel (the PSP) with the State of Queensland (the Principal) to eligible
customers as defined under that PSP (Customers1).
B. The Worker wishes the Supplier to put forward the Worker for temporary roles with Customers,
from time to time.
C. In assessing whether to engage the Worker for temporary roles, Customers may require criminal
history checks to be conducted on the Worker (either by the Customers or by the Supplier on their
behalf) and information relating to the outcome of the criminal history checks to be shared with
the Supplier.
D. During any engagement of the Worker in a temporary role with a Customer, the Customer will
want to share information related to the performance of the Worker with the Supplier, the
Principal, other Customers and relevant service providers to the PSP, including the vendor
management system supplier and the resource manager which manages the system.
E. To be considered for engagements for temporary roles with Customers, the Worker is required to
provide the consents set out below.

Contingent Worker Consent

I hereby,
• consent to Customers (or the Supplier on their behalf) undertaking criminal history checks in
relation to roles for which I wish to be put forward for consideration;
• consent to information2 related to the outcome of a criminal history check being shared between
the Customer which required the criminal history check and the Supplier;
• consent to information related to my performance in a temporary role with a Customer, should I
be engaged in that temporary role via the Resource Manager Service 3, be accessible by the
Supplier, the Principal, current and future Customers and relevant service providers to the PSP,
including the vendor management system supplier and the resource manager which manages the
system, for the purposes of:
a) managing the procurement of services;
b) reviewing my performance under the engagement; and
c) assessing my suitability to perform services under any future contracts with Customers.

Contingent Worker Name Fazal DIn

Supplier Name Empire Careers Queensland Partnership

Contingent Worker Signature4

Date
15/11/2023

1 Allof the following entities are eligible Customers under the Queensland Government Temporary and Contracted Workers
Preferred Supplier Panel:
(a) Queensland Government departments and agencies;
(b) Queensland Government Bodies;
 Contingent Worker Consent Form

(c) any entity which is directly or indirectly, partially or entirely funded by the State of Queensland, and/or a community based,
non-profit making organisation performing community services, and/or another entity, from time to time approved by the
State of Queensland as an eligible Customer under the SOA; and
(d) the Commonwealth, another State or a Territory government.
2 Any personal information held by Customers and the other parties mentioned above are subject to the Information Privacy Act
2009 (Qld) or the Privacy Act 1988 (Cth).
3
Personal Information collected within the Resource Manager Service is transferred outside of Australia but must be done so
by the supplier in accordance with section 33 of the Information Privacy Act (transfer of personal information outside of
Australia) and the provisions of the relevant government ICT frameworks.
4 The Worker’s signature may be provided electronically, in accordance with the requirements stipulated in relevant legislation
including the Commonwealth (1999) and Queensland Government (2001) Electronic Transactions Acts.

Version 3 – Sept 2021 2