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Step Three: Sign a Contract

Step Three: Sign a contract with the Respite contractor

We suggest  that you sign a Contract with the Respite contractor.  Here is a sample contract you might use, or change to meet your needs. 

Please note that it is not legally binding.

A condensed sample is below; however, a printable copy is available here for download: Step 3 contract.doc (55296 B)

It is also suggested that you review any signed contracts with a Respite contractor on a yearly basis.

SAMPLE CONTRACT:

Name of person to receive respite care:______________________

 

Describe the care and activities required

In the home

Out of the home

Additional comments

 

 

 

 

 

 

 

 

 

Medication requirements (if required to give medication):

 

 

 

 

 

 

 

 

 

 

 

 

 

Rate and frequency of pay

Hourly

 

Daily

 

Overnight rate

 

Flat 24 hour rate

 

When and how often the

Respite contractor will be paid?

 

 

Scheduling

Contacting Respite Contractor

 Contacting Me

Best way to contact

 

 

Times to contact

 

 

Hours notice to be given  to cancel

 

 

Hours notice to be given to book

 

 

 

 

Expenses  (activity fees; for example, cost of transportation, admission to the movies, meals while out, etc)

Covered by us

Not covered by us

(to be paid by Respite contractor)

Comment

 

 

 

 

 

 

Smoking

In our home

In the Respite contractor’s home

In the community

In the vehicle:( smoking is against provincial law when transporting those under the age of  16)

Yes or no

 

 

 

 

 

As a self-employed independent Respite contractor,

  • I am responsible for reporting my own income and to make appropriate Canada Pension Plan, Employment Insurance premiums, Income tax and GST/HST remittances if needed. 
  • I will carry vehicle liability insurance if I am providing transportation.
  • I will carry my own liability insurance if I consider it to be needed.

 

The family has no responsibility for remitting all necessary statutory payment and remittances.  For example: a T4 slip, vacation pay, provincial medical plan,  Workplace Safety and Insurance coverage, Employment Insurance premiums, higher rate of pay for overtime hours, severance pay etc.

 

When providing the above care in this capacity, the self-employed independent Respite contractor  is not an employee of:  Access Better Living Inc., Cochrane Temiskaming Extend-a-Family, Cochrane Temiskaming Resource Centre, Cochrane Temiskaming Children’s Treatment Centre, Community Living Iroquois Falls, Community Living Kirkland Lake, Community Living Temiskaming South, Community Living Timmins, Cochrane Community Living, Kapuskasing and District Association for Community Living, Hearst Community Living, Child and Family Services of Timmins and District/autism program.

 

Ending the contract

Days notice will be given

If the Respite contractor wishes to end the contract

 

Should Parent/guardian wish to end the contract

 

However; Abuse (verbal, physical, emotional, financial) or suspicion of abuse will result in an immediate end to this contract.

  immediate

 

Agreement:  This agreement is signed in respect of each person’s confidentiality

I agree with all of the above

Date:

 

*Contract is agreed to from

Date:

To date:

Respite contractor signature

 

 

 

Parent/guardian/caregiver’s signature

 

 

Signature of person receiving care

 

 

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