Free independent contractor agreement 31
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ACI Enterprises Inc.
6480 Weathers Place, Suite 300, San Diego, CA 92121
ACI Provider Relations: [email protected]
Tel: (858) 736-0047 | Fax: (858) 452-7819

INDEPENDENT CONTRACTOR AGREEMENT
PLEASE PRINT OR TYPE

The independent contractor agreement is made this

day of

by ACI ENTERPRISES, INC. (ACI) and

, 20

(Contractor). The Contractor will provide assessment,

counseling and referral of appropriate clients referred by ACI. ACI requires that all counseling services be performed
within a reasonable period of time of request for such services. Contractor represents him/herself to be licensed or
certified by the State of
License #

as a

,

, and shall maintain such license or certification for the duration of this agreement.

Contractor shall be paid only for authorized services. The payment arranged by ACI and agreed to by Contractor under
the terms of this Agreement shall be payment in full to Contractor who shall not under any circumstances seek any
further payment f