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					Murdoch University Private Consultancy Form
This form must be completed and submitted to your Divisional Head or Executive Dean whenever you engage in a Private Consultancy. A Private Consultancy is the provision of professional advice or services to an external party for a fee or other non-monetary consideration. You should refer to the Murdoch University Consultancy Policy before completing this form.

APPLICANT DETAILS
APPLICANT NAME(S): STAFF NUMBER: APPLICANT’S AOU: APPLICANT'S DIVISION

PRIVATE CONSULTANCY DETAILS
NAME OF CLIENT OR CONTRACTING PARTY:

PROJECT TITLE:

APPLICATION DATE:

COMMENCEMENT DATE:

TERMINATION DATE:

PROJECT TIME (days/month):

PROVIDE A BRIEF DESCRIPTION OF THE PROPOSED CONSULTANCY (attach additional page if necessary):

PRIVATE CONSULTANCY CONDITIONS
In signing this form, the Staff member warrants the following (indicate by ticking the box): 1. 2. That he/she has read and agrees to comply with the Murdoch University Consultancy Policy. Agree



That either no University facility (including power, space and equipment) will be used in such Private Consultancy, or where such use is envisaged, that the use of such facilities will be undertaken on the basis of Full Cost Recovery under the terms of a separate written agreement between the Staff member and the Divisional Executive Dean (a copy of any such agreement referred to in this clause must be attached to this approval form). Agree That the proposed Private Consultancy will not affect the Staff member’s ability to satisfactorily perform his or her normal duties of employment at the University in accordance with his or her contract of employment. Agree That the proposed Private Consultancy will not conflict with any areas of interest to the University. This includes: i. ii. ethical interests, and that the proposed Consultancy does not compete with services provided by the University on a commercial basis or offers services within an area where the University would normally offer services on a commercial basis. Agree

 

3.

4.

 

5.

That no administrative or technical area of the University (including, but not limited to, Financial Services, Human Resources, University Secretariat, Division of Research & Development, School or Divisional Office) provides or will provide any service in support of the proposed Private Consultancy Agree That no University letterhead, stationery, postal address, phone number, fax number, e-mail address or Web address is to be used, nor any other information which might associate the University with the Private Consultancy in any way. Agree That any payments relating to the proposed Private Consultancy will be made direct to the consultant and not through the University or the Commercial Consulting Company. Agree That where the proposed Private Consultancy is to make use of animal or human subjects, the work will be carried out within the same ethical guidelines that would apply if the University undertook the work. Agree That the University is expressly and specifically dissociated from the Private Consultancy, and the Staff member will not associate the University with such Private Consultancy or permit the external party to do so in any way. Agree

6.

  

7.

8.

9.

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10. That the Private Consultancy contract will contain the Liability Disclaimer below: a. In providing the services that are the subject of this contract the consultant: i. ii. acts as an independent contractor; and is not acting in the capacity of an employee or agent of, does not act for or on behalf of, and is not in any way connected or associated with, Murdoch University or any company or entity owned or associated with Murdoch Investments Pty Ltd (a “University Company”);

b.

Murdoch University and all University Companies will not be liable to the parties or either of them, nor will the parties or either of them make any claim against the University in respect of any loss or claim of any nature whatsoever and howsoever (including without limitation loss of profit, special or consequential damage and legal costs on a full indemnity basis) arising out of, related to or connected with this contract. The benefit of this provision is agreed to be taken and held by the Consultant in trust for Murdoch University and all University Companies, with the intent that the beneficiaries of such trust may enforce such provision, directly; and The parties and each of them agree to indemnify and will keep Murdoch University indemnified against any claim or loss by any person, of any nature whatsoever and howsoever (including without limitation loss of profit, special or consequential damage and legal costs on a full indemnity basis) arising out of, related to or connected with this contract. The benefit of this provision is agreed to be taken and held by the Consultant in trust for Murdoch University and all University Companies, with the intent that the beneficiaries of such trust may enforce such provision, directly.

c.

(Where the parties do not intend to have a formal Private Consultancy contract, then the Staff member can use the pro-forma letter attached to this form, for the purposes of ensuring the external party is made aware of the Disclaimer.) Agree 11. That the Staff member will lodge with the Division of Research and Development and the Commercial Consulting Company a copy of the Private Consultancy contract, or a statutory declaration as to his or her compliance with the Policy (namely, by the inclusion of the Liability Disclaimer in any agreement between the Staff member and the external party), within 30 days of the commencement of any Private Consultancy. Agree

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

IMPORTANT
Please read and indicate your acknowledgement of this section by ticking the box. Under a Private Consultancy, the Staff member enters into a contract with an external party (the Private Consultancy contract), receives the proceeds from the Consultancy and accepts full responsibility for the performance of the contract. The University bears no contractual, legal or insurance liability for the Consultancy whatsoever. Therefore, the University strongly advises you to obtain your own professional indemnity insurance, and legal and taxation advice. Agree 

SIGNATURES
APPLICANT’S SIGNATURE: DATE:

Acknowledgement of receipt by Divisional Head/Executive Dean – I confirm that no aspect of the proposed Consultancy activity contravenes University policy as set out in the Murdoch University Consultancy Policy.
DIVISIONAL HEAD/EXECUTIVE DEAN'S SIGNATURE: DATE:

Acknowledgement of receipt by the University Commercial Consulting Company
SIGNED ON BEHALF OF UNIVERSITY COMMERCIAL CONSULTING COMPANY: DATE:

Pro-forma letter containing Liability Disclaimer for Private Consultancies 


This letter can be tailored by adding the names of the parties This letter is NOT to be used on a Murdoch letterhead or other stationary bearing the Murdoch name, crest or logo.

____________________________________________________________________________

Dear______________________, I refer to the arrangement that you/your company, ___________________________(name/ACN) of _______________________ (address) and myself, ____________________ have entered into, whereby I will be providing my services to you (“the Consultancy’). As an employee of Murdoch University (“Murdoch”), I am required to specifically disassociate any involvement by, and connection of, Murdoch in respect of the Consultancy. To this end, the following clauses must be incorporated into the Consultancy contract that documents the terms of the provision of my services to you and the arrangement generally: a. iii. iv. In providing the services that are the subject of this contract the consultant: acts as an independent contractor; and is not acting in the capacity of an employee or agent of, does not act for or on behalf of, and is not in any way connected or associated with, Murdoch University or any company or entity owned or associated with Murdoch Investments Pty Ltd (a “University Company”); Murdoch University and all University Companies will not be liable to the parties or either of them, nor will the parties or either of them make any claim against the University in respect of any loss or claim of any nature whatsoever and howsoever (including without limitation loss of profit, special or consequential damage and legal costs on a full indemnity basis) arising out of, related to or connected with this contract. The benefit of this provision is agreed to be taken and held by the Consultant in trust for Murdoch University and all University Companies, with the intent that the beneficiaries of such trust may enforce such provision, directly; and The parties and each of them agree to indemnify and will keep Murdoch University indemnified against any claim or loss by any person, of any nature whatsoever and howsoever (including without limitation loss of profit, special or consequential damage and legal costs on a full indemnity basis) arising out of, related to or connected with this contract. The benefit of this provision is agreed to be taken and held by the Consultant in trust for Murdoch University and all University Companies, with the intent that the beneficiaries of such trust may enforce such provision, directly.

b.

c.

Where there is no formal written contract, these provisions are to be treated as terms of the relationship between myself and you/your company as it relates to the Consultancy, as if they were part of a written contract.

Yours sincerely

__________________________________________ (Signature of Murdoch Staff member) Name of Murdoch Staff member: Date:

Copies to: 1. Divisional Executive Dean Murdoch University

2. University Commercial Consulting Company Murdoch University


				
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posted:11/22/2009
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