RIVERVIEW School District No 407
                                   32240 NE 50th Street • Carnation, WA 98014 • (425) 844-4500 • FAX (425) 844-4514

                                             CONTRACT FOR SOLE PROPRIETOR
                           The undersigned individual agrees to furnish to Riverview School District the following services:

Audiology services for the Riverview School District and its students. To include checks of FM Systems, adjusting FM Systems,

instructions to staff on how to use FM Systems and any other services that fall within this person's exptertise.

Contract Beginning Date _____________ Ending Date ______________ Payment is to be made at the following rate

                                         plus                                              for a total not to exceed:
       Hourly rate or flat fee                         Additional Expenses: Mileage/food

Vendor agrees that he/she is not an employee of the Riverview School District and that he/she shall remit all
withholding taxes as required by law.

       Vendor Name - Same as reported to IRS (Please type or print)                        Signature of Person Initiating Request                     Date

                            Street address or P.O. Box                                     Signature of Admin./Super. of School/Depart                Date

                                    City, State, Zip                                       Signature of Student (ASB)                                 Date

                            Telephone Number (Day)                                         Board Approval                                             Date

                             Social Security Number                                                Account Code (RVSD Staff to complete)                  Amount

You must report actual hours worked, with student's name,
under this contract on each billing statement

                                                                         Acceptance of Contract
NOTICE TO VENDOR: Vendor agrees by signature of contract that services are not to begin until approved purchase order has been issued.
The District must be in receipt of the individual's Social Security Number or Unified Business Identification number in order to issue a
purchase order.
As part of this agreement between Riverview School District and the contractor, it is agreed that payment for services satisfactorily rendered,
shall be mailed to the vendor or made available to the vendor within sixty days of receipt of properly completed invoice. All invoices must
reference the purchase order number and include actual hours worked for the period covered by the invoice and mailed to: Riverview
School District No. 407 Accounts Payable, 32240 NE 50th St Carnation WA 98014.

Certification Regarding Debarment, Suspension, and Ineligibility.
 First Choice In-Home Care certifies that neither it nor its principals are presently debarred, declared ineligible, If federal funds
are the basis for this contract,or voluntarily excluded from participation in transactions by any federal department or agency.

                                 Signature of Vendor                                                               Date Signed by Vendor

                                                                                                                            2010 Contract for Sole Proprietor.xls 11/25/2009
2010 Contract for Sole Proprietor.xls 11/25/2009

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