*AGREEMENT BETWEEN MIDDLE TENNESSEE STATE UNIVERSITY AND (CONTRACTOR) This Agreement is made this _____ day of ____________________, 20___, by and between Middle Tennessee State University, hereinafter referred to as "Institution", and ____________________, hereinafter referred to as "Contractor". In consideration of the mutual promises herein contained, the parties have agreed and do hereby enter into this Agreement according to the provisions set out herein: 1. Contractor agrees to perform the following services: ____________________________________________ ______________________________________________ 2. Institution agrees to compensate Contractor as follows: a. Rate of compensation:__________________________ 3. b. Timetable for payments:_________________________ c. Contractor shall _____ shall not _____ be compensated or reimbursed for travel expenses. If applicable, payment to Contractor for travel, meals or lodging shall be in the amount of actual cost or per diem, subject to maximum amounts and limitations specified in the Tennessee Board of Regents policies, as they may be from time to time amended. d. The final payment shall be made only after Contractor has completely performed its duties under this Agreement. e. In no event shall the liability of Institution under this Agreement exceed $________________ Contractor warrants that no part of the total contract amount provided herein shall be paid directly or indirectly to any officer or employee of the state of Tennessee as gifts, wages, or compensation in exchange for acting as officer, agent, employee, sub-contractor, or consultant to Contractor in connection with any work contemplated or performed relative to this Agreement. If Contractor is an individual, Contractor warrants that within the past six months he/she has not been and during the term of this Agreement will not become an employee of the state of Tennessee. 4. The parties shall maintain documentation for all charges and services under this Agreement. All books, records and documents, insofar as they relate to work performed or money received under this Agreement, shall be maintained for a period of three (3) years from the date of final payment, and shall be subject to audit, upon notice, by Institution or the Comptroller of the Treasury or their duly appointed representatives. 5. This Agreement may be terminated by either party by giving written notice to the other, at least ___ days before the effective date of termination. In that event, Contractor shall be entitled to receive just and equitable compensation for any satisfactory, authorized work completed as of the termination date. This Agreement may be terminated without the above described notice if performance is prevented by an act of war, order of a legal authority, act of God, or other unavoidable causes not attributed to the fault or negligence of either party. Institution may also terminate this Agreement if it becomes aware of any threat to personal or public safety arising at the intended time of performance. 6. Contractor, being an independent contractor and not an employee of Institution, agrees to carry adequate liability and other appropriate forms of insurance, to pay all taxes incident hereto, and otherwise protect and hold Institution harmless from any and all liability not specifically provided for in this Agreement. 7. Institution is committed to providing accessible information, materials and technologies to assure that individuals with disabilities have access to Institution resources comparable to access that is available to others. 8. The parties also agree to comply with applicable state and federal law, including but not limited to, any applicable nondiscrimination or affirmative action requirements. This Agreement shall be governed by and construed in accordance with the laws of the state of Tennessee. Any and all claims against Institution or its employees based upon this Agreement shall be heard and determined by the Tennessee Claims Commission in the manner prescribed by law. 9. The term of this Agreement shall be from: _____________________ to ___________________. 10. If Contractor fails to fulfill in a timely and proper manner its obligations under this Agreement, or if Contractor shall violate any of the terms of this Agreement, Institution shall have the right to immediately terminate this Agreement and withhold payments in excess of fair compensation for work completed. 11. PCI DSS Compliance. If Contractor will accept credit or debit cards in its performance under this Contract, Contractor agrees that it will at all times during the performance of this Contract comply with current Payment Card Industry Data Security Standards (PCI-DSS standards). 12. Illegal Immigrants. By acceptance of this Agreement, Contractor is attesting that it will not knowingly utilize the services of illegal immigrants and will not knowingly utilize the services of any subcontractor that does so in performance of this Agreement. If Contractor is discovered to have breached this attestation, Contractor shall be prohibited from supplying goods and/or services to any TBR institution or other state entity for a period of one (1) year from date of discovery of the breach. Contractor may appeal the one (1) year by utilizing the established appeals process. 13. If Contractor makes sales to customers in Tennessee of taxable goods and/or services, Contractor shall be registered with the Tennessee Department of Revenue for the collection of TN sales and use tax and must provide a copy of its certificate of registration to Institution. If Contractor does not make sales to customers in Tennessee of taxable goods or services and marks Not Applicable below, its authorized signature on this Agreement shall serve as certification of compliance with this requirement. Mark as appropriate below: Certificate provided ________ OR Not applicable_______ In witness whereof, the parties have by their duly authorized representatives set their signatures. Middle Tennessee State University (Contractor) BY: __________________________________ Date: _____________ Alan R. Thomas, Interim Vice President, Business & Finance BY: ________________________________ Date: _____________ *This short-form agreement is approved solely for use by Governor’s School for the Arts, MTSU’s Band of Blue, and/or MTSU Theatre and Dance.