CITY OF EUGENE <br /> INDEPENDENT CONTRACTOR CERTIFICATION STATEMENT <br /> To qualify as an independent contractor you must certify that you meet the following standards as <br /> required by ORS chapters 316, 656, 657 and 701: <br /> I <br /> (1) You provide labor and services free from direction and control, subject only to the <br /> accomplishment of specified results. <br /> I <br /> (2) You are responsible for obtaining all assumed business registrations or professional <br /> occupation licenses required by state or local law. <br /> (3) You furnish the tools or equipment necessary to do the work. <br /> i <br /> <br /> J (4) You have the authority to hire and fire employees <br /> (5) You are paid on completion of specific portions of the project or on the basis of a periodic <br /> retainer (payment by the hour also qualifies). <br /> (6) You filed federal and state income tax returns for the business for the previous year if you <br /> performed labor or services as an independent contractor in the previous years. <br /> (7) You represent to the public that you. are an independent business, as follows: <br /> YOU MUST INDICATE THAT YOU MEET FOUR (4) OR MORE OF THE FOLLOWING: <br /> A) You work primarily at a location separate from you residence. <br /> I <br /> B) You have purchased commercial advertising, business cards, or have a <br /> professional/trade association membership. <br /> C) You use a telephone listing and service separate from your personal residence <br /> listing and service. <br /> D) You perform labor or services only pursuant to written contracts <br /> E) You perform labor or services for two or more different persons within a period of <br /> one year. <br /> F) You assume financial responsibility for defective workmanship and breach of <br /> contract, as evidenced b erformance bonds or liabili insurance covera e. <br /> YP t 9 <br /> SIGNATURE: I hereby certify that to the best of my knowledge the information provided is complete <br /> and correct. I hereby certify that the business will operate as an independent contractor as stated <br /> above. <br /> Signature of Owner, Partner, or Corporate Officer Date <br /> Standard Contract Provisions-Page 13 <br /> (Revised Nov. 1999) <br /> <br />