Agreement With Caregiver

1. GERI-CARE CONNECTION AGREEMENT WITH CAREGIVER   AGREEMENT made____________________, ___________,  by and between Geri-Care Connection, L.L.C., 158 Jelliff Mill Road, New Canaan, CT 06840 ("Geri-Care") And________________________________("Caregiver").   In consideration of the mutual promises and covenants contained herein,  the Parties agree as follows: 1. Independent Contractor  The Caregiver acknowledges that he/she is an Independent Contractor, not an employee of Geri-Care.  As an independent Contractor, the Caregiver acknowledges that he/she is allowed to accept or reject any assignment to provide care to any Client.  The Caregiver is solely responsible for paying taxes on any compensation that the Caregiver receives for providing services to the Clients.  The Caregiver or the Client, not Geri-Care,  is responsible for providing any products or resources that are needed to provide care to the clients. Geri-Care will not be responsible to provide workers compensation benefits in the event that the Caregiver is injured in the course of providing services to the clients. 2. Referrals  The Caregiver grants Geri-Care the right to refer the Caregiver to the Third Parties for the position of a Caregiver to provide Home Care Assistance.  The Caregiver shall provide Geri-Care upon the execution of this agreement with three Professional References.  Caregiver acknowledges and agrees that the sole obligation of Geri-Care hereunder shall be to make referral to Caregiver of Third Parties who need home care assistance.   3. Working Privately  No Caregiver will work privately for clients or receive private pay without reporting all wages to Geri-Care.  The caregiver cannot work privately for the Geri-Care client after the assignment has terminated for one year.   4.  Reporting of Earnings to Geri-Care  The Caregiver shall report his/her earnings to Geri-Care each week, or portion of a week, that the Caregiver is retained by a person Geri-Care referred him/her to in the form of a time sheet.  This time sheet shall include the name and address of the person and the amount of compensation paid, and the dates of service and on the reverse side the notes of services performed.   5.  Non-Liability and Indemnification  The Caregiver hereby acknowledges and agrees that Geri-Care makes no representations with respect to the Third Party for which the companion service will be provided.  Accordingly, the Caregiver agrees that Geri-Care shall not be liable to the Caregiver, and the Caregiver shall save Geri-Care harmless from all liability, claims, damages and expenses, including reasonable attorney's fees, in connections with any actions of the Caregiver or the third party.   6. Providing Truthful and Legal Documents  The Caregiver will provide Geri-Care with legal documents.  The documents will not belong to anyone else of have not been obtained illlegally.  The references provided to Geri-Care are those of a professional relationship the Caregiver had in the past or in the present. Geri-Care is not responsible for information furnished which is falsified by Caregiver.   7.  Termination of Agreement  The Caregiver can terminate this agreement whenever they want, but the Caregiver cannot work for a Geri-Care client for one year. Geri-Care can terminate this agreement whenever they see fit for the protection of the Client and the Company.   8.  This agreement shall not be construed to create an employer-employee relationship between parties, or a partnership joint venture, and agency.  Geri-Care shall have no liability to the Caregiver if the Third Party fails to pay the Caregiver for his/her services.  Caregiver will work as Independent Contractor and be responsible for own Workmen Compensation Insurance.  No claims shall come against Geri-Care or client in the event that Caregive is hurt on job.   9.  Entire Agreement.  This Agreement contains the entire understanding between Geri-Care and the Caregiver, and may be amended only in writing signed by each party. IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of the day and the year of the first above written.   GERI-CARE CONNECTIONS L.L.C.   BY_______________________________________________       Caregiver