INDEPENDENT CONTRACTOR AGREEMENT
NOTE: THIS FORM APPLIES ONLY TO THE STATE OF ARIZONA AGENCIES, BOARDS,
COMMISSIONS, AND UNIVERSITIES UTILIZING INDEPENDENT CONTRACTORS.
THIS FORM DOES NOT APPLY TO EMPLOYERS IN THE CONSTRUCTION INDUSTRY THAT USE
A CONTRACTOR. A CERTIFICATE OF WORKERS' COMPENSATION INSURANCE OR A SOLE
PROPRIETOR WAIVER MUST BE OBTAINED IN THOSE INSTANCES.
This is a written agreement under the compulsory Workers' Compensation laws of the State of Arizona,
A.R.S. § 23-901 (et. seq.), and specifically A.R.S. § 23-902 (C), (D), that an independent contractor
relationship exists between the parties signed below. The parties agree that the "independent contractor"
is independent of the "business" in the execution of the work and not subject to the rule or control of the
"business" but is engaged only in the performance of a definite job or piece of work and is subordinate to
the "business" only in effecting a result in accordance with that "business" design. The parties also a