Harmony Helpers USA, LLC 

APPLICANT AGREEMENT 

​

Undertaking and Instructions to Registry/Agency 

​

Employees/1099 Workers agree to provide Harmony Helpers USA LLC, with such contractual services that it may obtain or procure for me and that I accept the responsibilities of an Applicant. 

​

That I have required said Registry/Agency not to withhold or deduct any part or amount from any and all remuneration, compensation, or salaries due me; that there shall be no deductions made, effected or applied for Federal or State income taxes, including Social Security taxes, State disability insurance, for and on behalf of me. 

​

That, further, I shall solely be responsible for any and all taxes, unemployment insurance due to or to be due, whether Federal or State, including any Social Security taxes, arising out of my compensation due from said Registry/Agency and I hereby waive any and all claims against said Registry/Agency in connection therewith. 

​

That, finally by signing this agreement, I am holding said Registry/Agency free and harmless of any liability that may arise in connection with my contractual relationship with it. 

​

This Applicant Agreement is entered into by and between Harmony Helpers, and Employees/1099 Workers, hereafter called "Applicant", whose Social Security Number was provided to serve and perform such duties at such times and places and in such a manner as “Harmony Helpers” may from time to time offer to the Applicant on an "as available" basis. 

I. Harmony Helpers agrees to furnish Applicant with temporary jobs from time to time 

which the Applicant may choose to accept or reject. 

II. 

In consideration of such services, Harmony helpers agrees to pay Applicant compensation at a rate to be determined from time to time. 

Applicant agrees to faithfully perform the duties secured by him/her to the best of his/her ability; to devote his/her undivided time to the transaction of Harmony Helpers business; to provide his/her own equipment, proper dress, and transportation; to comply with all federal, state, and local laws regarding business permits and licenses at Applicant's own expense; to make to Harmony Helpers prompt, complete and accurate reports of his/her work record and timeslips. Applicant agrees and acknowledges that any ideas, 

know-how, trade secrets, customer information, and lists of proprietary and confidential data provided to Applicant shall be considered confidential and proprietary and shall be Harmony Helpers valuable business and property rights at all time during and after the term of contracted work; and any information disclosed to Applicant whether written, oral, physical or otherwise, shall not be used or disclosed by Applicant to anyone else except as expressly may be permitted by Harmony Helpers. Applicant agrees to hold Harmony Helpers harmless from any and all liability resulting from the acts of the Applicant during the contracted work, and during the time of travel to and from the contracted work. Applicant also agrees to hold Harmony Helpers harmless from any and all liability resulting from the injuries suffered by Applicant during the contracted work, and during the time of travel to and from the contracted work. Applicants will be solely responsible for any and all worker's compensation claims and taxes. It is agreed that Harmony Helpers will not pay for or cover the Applicant for professional liability. 

​

Applicant further agrees that during the term of his/her contract with Harmony Helpers and for the first two years after termination of this contract: 

A. Applicant shall not directly or indirectly induce any person to leave his/her registration with Harmony Helpers  unless Applicant has first obtained the written approval of Harmony Helpers. 

B. Applicant shall not do or engage in any act which is prejudicial or injurious to the 

business or good will of Harmony helpers

C. Applicant shall not invest in or advise any business or entity which directly competes 

with Harmony Helpers and/or within one mile of Harmony Helpers.. 

 

This contract shall be in effect from the date of this agreement for a period of one year, automatically renewing, until it is terminated by either party at any time, upon thirty (30) days written notice to the other party. The said written notice is not required by Applicant if Harmony Helpers has not complied with the provisions in Article II and is not required by Harmony Helpers if Applicant has not complied with the provisions of Articles III and IV of this contract. At the termination of this contract, the payment to Applicant of monies earned to the date of such termination shall be in full satisfaction of any monetary, discrimination, benefits, vacation, and other types of claims brought by Applicant against Harmony Helpers under this contract. 

​

Harmony Helpers shall not provide Applicant any fringe benefits not explicitly set forth herein or subsequently specifically agreed to by the parties. It is agreed that Harmony Helpers  will not withhold any taxes or deductions from Applicant's paychecks. Applicant shall be solely liable for his/her own F.I.C.A., withholding tax, unemployment, and all other taxes imposed under the law, and waives any claims against Harmony Helpers in connection thereof. 

 

The invalidity or unenforceability of a particular provision of this contract shall not affect the other provisions hereof, and this contract shall be construed in all respects as if such unenforceable provision were unnoted. 

This contract is non-assignable by Applicant. 

In any suit to enforce this contract, venue shall be in Broward County, Florida, and/or Cobb County, GA shall be entitled to the following cumulative and non-elective remedies: 

A. Temporary and permanent injunctive relief to prevent prospective irreparable injury. 

B. Temporary and permanent injunctive relief to enforce compliance with any provisions 

of this contract prior to or after termination hereof. 

C. Company's liquidated damages, Harmony Helpers general damages, if damages 

are not liquidated. 

D. Court costs to enforce or have its rights declared under this contract. 

No modification or waiver or any covenant, condition, or limitation of this contract shall be valid unless the same be in writing and signed by the parties hereto. This agreement shall be construed in accordance with the laws of the State of Florida. 

 

TERMS AND CONDITIONS FRINGE BENEFITS INDEPENDENT CONTRACTOR

Because IC is engaged in IC's own Applicant business, IC is not eligible for and shall not participate in, any employer pension, health, or other fringe benefit plan of the CLIENT. 

NOTICE TO IC REGARDING ITS TAX DUTIES AND LIABILITIES 

IC understands that IC is responsible to pay, accordingly, to existing laws, IC's income taxes. If IC is not a corporation, IC further understands that IC may be liable for self-employment (social security) tax, to be paid by IC according to law. 

CLIENT NOT RESPONSIBLE FOR WORKERS' COMPENSATION 

No workers' compensation insurance shall be obtained by CLIENT concerning IC or the employer of IC. IC shall comply with the workers' compensation law concerning IC and the employer of IC. 

TERM OF AGREEMENT 

This agreement shall terminate by either agency and or employee upon verbal or written notice. 

TERMINATION WITHOUT CAUSE 

Without cause, either party may terminate this agreement after giving thirty (30) days written notice to the other of the intent to terminate without cause. 

TERMINATION WITH CAUSE 

With reasonable cause, either party may terminate this agreement effective immediately upon giving written notice or termination for cause. Reasonable cause shall include: 

1. Material violation of this contract 

2. Any act exposing the other party to liability to others for personal injury or property 

damage. 

NO AUTHORITY TO BIND CLIENT 

IC has no authority to enter into contracts or agreements on behalf of CLIENT. IC is not authorized to act for the CLIENT in any way. 

DECLARATION BY APPLICANT 

IC declares that IC has complied with all federal, state, and local laws regarding business permits and licenses that may be required to carry out the work to be performed under this agreement. 

 

ASSIGNABILITY 

This agreement may not be assigned, in whole or in part by IC without the written consent of the CLIENT. 

ENTIRE AGREEMENT 

This is the entire agreement of the parties and cannot be changed or modified orally. 

AMENDMENTS 

This agreement may be supplemented, amended, or revised only in writing by agreement of both parties. 

 

GENERAL ASSIGNMENT 

We are very happy to have you become a member of our family. The following standards and policies are designed to help ensure that you are welcomed to all the job assignments that you accept and to assist you in delivering the highest quality service as a representative of our Registry/Agency family. 

We are a Registry/Agency and cannot guarantee any set number of hours per pay period. Even if you have worked a full week, we cannot guarantee the same number of hours in the following weeks or months. You are responsible for your own transportation. If you do not have a car, the Registry/Agency cannot guarantee placement close to home or local transportation routes. We will make every effort to accommodate your needs and desires within reason, whenever possible. 

 

III.STANDARDS WITHIN CLIENT FACILITIES 

A. Interpersonal difficulties within any of our client facilities-whether they are with a co- worker or a client-must be brought to the attention of the Director. Avoid any confrontations and notify the Director immediately. 

B. Staff are expected to arrive on time to all assignments which have been accepted. If an emergency arises and you are going to be late, notify the Registry/Agency office immediately. Never call the client directly! 

C. Cancellation of assignments on a regular basis is unacceptable. The honoring of all commitments made on accepted assignments is a hallmark of professional behavior. Excessive and routine cancellations may result in termination. (Also see Item J below.) 

D. The placing, and accepting, of personal phone calls on the nursing units within client 

facilities or on private duty client's phones is an unacceptable practice. 

E. The acceptance of gratuities or gifts by a client is considered an unprofessional and 

unacceptable practice. 

F. It is your responsibility to keep the Registry/Agency office aware of the days and shifts you are available to work on a weekly basis. This helps the Registry/Agency office to plan staffing with the client hospitals and assists in the accommodation of the Applicant in the shift assignments desired. 

G. Special attention must be paid to the completion of the sign-in sheets or time slips, as this is the only record of time worked with a given assignment. Sign in at the beginning of the shift and sign out at the end of the shift by the appropriate supervisor or the nursing office. Their initials must be on each overtime shift on the sign-in or time slip in order to be paid. 

H. Never leave an assignment without notifying the Registry/Agency office first. If you have a family emergency, have the responsible party inform the Registry/Agency office first. You will be subsequently informed. 

 

I. You must agree not to accept other employment (directly or indirectly) with clients assigned by this Registry/Agency for a period of twelve (12) weeks following any assignments by Registry/Agency. You understand that doing so is in violation of company policy and establishes liability in the amount of fifteen percent (15%) of the earnings for one (1) year with the client. 

J. Late cancellations by staff (canceling from a confirmed assignment) with less than two (2) 

hours' notice will result in a two (2) hour pay penalty. 

K. Failure to show for an assignment without canceling subjects you to dismissal and 

corrective action including a possible four (4) hour pay penalty. 

L. The Registry/Agency does not guarantee full-time employment and further does not 

guarantee a minimum number of hours worked each week. 

M. You must report any/all accidents or exposures to the facility supervisor and the 

Registry/Agency management immediately. 

N. You will receive a job description at the time of contract completion. It is the Applicant's responsibility to function within the limits of the stated job description, and State and local laws governing the practice of nursing. 

 

NON-DISCLOSURE OF CONFIDENTIAL CLIENT INFORMATION 

As an Applicant of Harmony Helpers, (Registry/Agency), has reviewed and clearly understands the Policies and Procedures regarding the Confidentiality of Information with respect to clients serviced by this Registry/Agency. 

Furthermore, I understand that any disregard and/or violation of this Registry/Agency's confidentiality rules and regulations, as currently stated in the Policies and Procedures Manual, or as amended from time to time, may be cause for disciplinary action up to and including immediate termination of my contract. 

Therefore, I hereby certify and agree as evidenced by my signature below, that under no circumstances of any kind shall I disclose any information, reports and/or inspections regarding the clients serviced by Harmony Helpers to any person other than the client without the express written consent of the client or client's guardian. Additionally, I agree that once such written consent is obtained and prior to disclosing any confidential client information, I shall first consult dissemination 

the Administrator of the Registry/Agency. I further understand and agree that any or disclosure of client information, reports and/or inspections shall under no circumstances be discussed in public places or elsewhere (except for Registry/Agency premises) including in my home or with my friends and family. Any such dissemination or disclosure of information may be cause for disciplinary action up to and including immediate termination of my contract. 

I hereby certify that I have read and fully understood the foregoing and I acknowledge that I am aware of the possible ramifications of violating the Registry/Agency's Policies and Procedures regarding Non-Disclosure of Confidential Client Information. 

 

Drug Free Workplace Addendum for Scheduled Healthcare Employers 

As outlined in the Company "Drug Free Workplace" policy, All Scheduled Healthcare Employers 

are considered a safety sensitive job classification and will be subject to unannounced routine 

fitness for duty testing and/or alcohol tests, at the company's discretion. 

I hereby understand that due to the safety sensitive nature of my job classification, I will be subject 

to unannounced routine fitness for duty drug and alcohol testing, at the company's discretion, as stated in the company Drug Free Workplace Policy and permitted under Florida statutes 440.101 and 440.102 and GA Code § 50-24-3 (2023)

 I hereby understand that due to job placement requirements of my job classification, 

may be subject to drug and/or alcohol testing immediately. I agree to submit to any drug and/or alcohol testing required as part of my job or job placement, effective immediately. I understand that this company will maintain on file all verified negative drug and alcohol test results. By signing this form, I authorize the release of these results by this company to any Medical Facility that requires a copy of these results, as part of my continuing placement at that facility. I understand that a refusal to test, an adulterated or tampered with specimen will result in immediate termination. I understand that a confirmed positive drug and/or alcohol test will result in the disciplinary action outlined in the company "Employee Acknowledgment Agreement Form. 

 

Harmony Helpers Representations and Warranties

You represent and warrant that you are qualified to perform services as a Harmony Helper through the Platform, and that all such services will be carried out professionally, promptly, and independently, without direction from Harmony Helpers. You further represent and warrant that you hold all necessary licenses, bonds, insurance, and meet all legal requirements set by federal, state, county, and local authorities to fulfill your obligations under this Agreement. You agree to maintain these qualifications throughout your engagement. Additionally, you represent and warrant that you have the legal right to enter into this Agreement, and that no existing agreements or arrangements (whether written or oral) will be breached by doing so or prevent you from fulfilling your role as a Harmony Helper. You also represent and warrant that you possess adequate liability insurance, workers' compensation insurance, and motor vehicle insurance as required.

 

Transportation Requirements

You agree to the following transportation requirements:

(a) Own or be fully authorized and insured to operate a personal motor vehicle registered in your name.
(b) Operate your vehicle safely and in compliance with all applicable federal, state, and local motor vehicle laws and regulations.
(c) Maintain your vehicle in safe driving condition.
(d) Hold a valid state driver’s license.
(e) Maintain automobile insurance that meets or exceeds state minimum requirements for death, bodily injury, and property damage. It is your responsibility to determine whether to obtain coverage beyond the minimum requirements, and we encourage you to consult with your insurance provider for guidance on this matter.

You agree to provide Harmony Helpers, upon request, with up-to-date certificates of insurance as proof of coverage, and to submit updated certificates whenever you purchase, renew, or modify your insurance. You also agree to notify Harmony Helpers at least thirty (30) days in advance of any cancellation of the insurance policies required by this Agreement.

Harmony Helpers reserves the right to review your motor vehicle history at least once per year, or as deemed necessary. Your continued participation in the Platform and your role as a Harmony Helper are contingent upon your consent to ongoing background checks and motor vehicle history reviews, which will be conducted by Harmony Helpers at least annually.

While driving, any use of a cell phone or other device for calls or GPS must be hands-free and comply with applicable federal and state laws. The use of any device for purposes other than hands-free calls or GPS, such as texting, emailing, streaming, or browsing the Internet, is strictly prohibited.

You must notify Harmony Helpers immediately in the event of a motor vehicle accident or upon learning of the suspension, revocation, or expiration of your driver's license. Failure to do so may result in the automatic termination of your role as a Harmony Helper.

When driving as a Harmony Helper or transporting a Harmony Helpers client, no family members, friends, animals, or other persons are permitted in your vehicle.

**Acceptable Use**

 

You agree not to access or use the Harmony Helpers Platform in any unlawful manner or for any illegitimate purpose, nor in any way that violates this Agreement. Specifically, you agree not to post, transmit, use, or store:

 

(a) Messages or information using a false identity;  

(b) Content that is illegal, defamatory, obscene, libelous, fraudulent, harassing, threatening, predatory towards minors, or hateful;  

(c) Information that infringes on the intellectual property, privacy, or publicity rights of others, including those of Harmony Helpers, its vendors, and affiliates;  

(d) Any material that may disparage Harmony Helpers, its employees, officers, directors, suppliers, vendors, agents, or independent contractors.

 

You further agree not to attempt to disrupt or interfere with the operation of the Platform by any method, including but not limited to, viruses, Trojan horses, worms, time bombs, denial of service attacks, flooding, or spamming. You shall not use the Platform in any manner that could damage, disable, or impair our services or networks.

 

You are prohibited from attempting to gain unauthorized access to user accounts, computer systems, or networks through hacking, password mining, or any other means. Additionally, the use of robots, scrapers, or other automated tools to access the Platform for any purpose is not permitted.

 

Lastly, you agree not to circumvent Harmony Helpers by engaging with clients or members outside the Platform, whether or not such engagement is done under the guise of providing services through Harmony Helpers.

 

**Media Consent and Release**

 

By signing this Agreement, you grant Harmony Helpers and its authorized parties, including licensees, advertising and promotion agencies, fulfillment agencies, and their respective employees, shareholders, officers, directors, managers, representatives, photographers, and agents (collectively referred to as "Authorized Persons"), full permission to photograph, record, reproduce, transmit, publish, and use in any form your likeness, legal or fictitious name, quotes, testimonials, interviews, audio recordings, photographs, and video footage. These materials, whether in full or in part, along with any reproductions or derivatives thereof (collectively, the “Materials”), may be used across all media, including but not limited to printed materials, television, online broadcasts, and social media, for purposes such as advertising, promotion, editorial use, and display, without any financial compensation or consideration to you.

 

By agreeing, you consent to being recorded or photographed and waive any rights to inspect or approve the resulting Materials or how they are used. You also relinquish any ownership or claims over the Materials, acknowledging that all rights, titles, and interests in the Materials belong solely to the Authorized Persons.

 

Furthermore, you release and agree to indemnify and hold harmless the Authorized Persons from any claims, demands, liabilities, or legal actions arising from the creation or use of the Materials. This includes any potential claims related to defamation, alteration, violation of privacy, publicity, intellectual property rights, or any other personal or property rights. Additionally, you waive any rights to compensation or royalties in connection with the use of the Materials, your name, or likeness.

 

You have the option to opt out of this Media Consent and Release at any time by contacting Harmony Helpers at info@harmonyhelpers.com.

​

Duties and Responsibilities: 

1. Helper should not assist in All personal care activities contained in a written assignment by a health professional 

employee, such as: 

a) Assisting the patient with personal hygiene. 

b) Assisting the patient with ambulation. 

c) Assisting the patient with eating. 

d) Assisting the patient with shaving. 

2. Patient-related activities as taught to the Home Health Aide by a professional employee 

for specific patient, such as: 

a) Assisting with change of colostomy bag. 

b) Assisting with shampoo. 

c) Assisting with reinforcement of dressing. 

g) Doing simple urine tests for sugar, acetone, and albumin. 

h.)Changing of sterile dressings. 

i.) Irrigating of body cavities, such as the use of an enema. 

j.) Irrigating a colostomy or wound. 

k.) Performing a gastric lavage of gavage. 

l.) Catheterizing a patient. 

m.) Administering medications. 

n.)Applying heat by a method. 

o.) Caring for a tracheotomy tube.