Service Agreement Checklist (SAC)

Service Agreement Checklist (SAC)

If this form is an amendment, please fill this form instead:

Amendment Form

Step 1. Identify Service Type

Is this request for a low risk independent contractor agreement?*

Yes

Category of Performance*

Note: If the category is not listed below, please select No on the previous question.

Musician/Artist/Performer

Speaker

Judge/Referee

Game Management

Service Type*

Cost Agreement

No Cost Agreement

Revenue Agreement

Step 2. Identify Agreement Type

Agreement Type*

District

Definition: Agreements that are developed by San Joaquin Delta College. The District has a few agreement templates available for use located at https://www.deltacollege.edu/campus-offices/administrativeservices/

purchasing/contracts-office. Confirm with your Department/TrAC manager if the available agreement templates

Non-District Agreement

Definition: Agreements that are developed by the Service Provider. Administration reserves the right for legal review on all Non-District Agreements. Note: Legal review typically takes three to six weeks.

District Agreement

Non-District Agreement

Step 3. Complete Steps a - o

a. Department/TrAC Name:*

Select

b. Division Name:*

Select or enter value

c. District Staff Member Name Completing the Checklist:*

d. District Staff Member Email:*

e. Supplier Business Name:

f. Supplier Point of Contact Name:*

g. Supplier Point of Contact Email Address:*

h. Supplier Point of Contact Phone Number:*

Phone

i. Supplier Authorized Signer Name:*

j. Supplier Authorized Signer Email:*

k. Amount of Agreement:*

l. Authorized Signer Phone Number:*

Phone

m. Term of Agreement Start Date:*

n. Term of Agreement End Date:*

Services cannot start until an agreement is signed by both parties. Agreements cannot exceed a 5-year term Per Education Code 81644.

o. Location of where the work will be performed:*

(Ex. main campus, remote only, etc.) District may require insurance from supplier depending on the type of work being performed. (Form can be found here: Insurance requirement)

Select

Scope of Services

Review the agreement and check the boxes to confirm the following has been identified. It is the responsibility of the Departments/TrAC offices to ensure a complete scope of service is provided. Leave unchecked if not applicable.

Describe the scope of work in detail for this agreement:*

Duties and Responsibilities:

Detailed description of the scope of services to be provided/performed is identified.

Specific tasks have been identified.

Compensation amount(s) tied to each tasks(s) (or percentage of work) and the not to exceed amount is identified.

District and Service Providers responsibilities clearly identified.

Timeline (milestones):

Start and end date is identified.

(Note: Services cannot start until agreement is signed by both parties. Agreements cannot exceed a 5-year term Per Education Code 81644.)

Specific due dates of each task(s) are identified.

Consequence(s) for missed or delayed milestone dates are identified.

Step 4. Complete Independent Contractor Evaluation (If applicable)

Departments/TrAC offices who intend to employ an entity/individual worker, as an independent contractor for the District, MUST complete the Independent Contractor Evaluation below following CA Supreme Court “ABC” test standards and select the correct response.

The worker is free from the control and direction of the hirer in connection with the performance of the work, both under the contract for the performance of such work and in fact;*

YES

The worker performs work that is outside the usual course of the hiring entity’s business; and*

YES

The worker is customarily engaged in an independently established trade, occupation, or business of the same nature as the work performed for the hiring entity.*

YES

If you have selected YES to ALL statements above, you have confirmed your Department/TrAC office is employing an independent contractor.

If you have selected NO to ANY of the statements above, then the individual is NOT an independent contractor.

REMINDER: A District employee cannot be employed as an independent contractor. If a District employee is hired to perform a service outside the scope of his/her normal duties, he/she MUST be paid through the payroll process.

Is the entity/individual a current District Employee*

YES

Has the entity/individual been a District Employee in the Current Fiscal Year*

YES