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8-19-19 Regular Meeting
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8-19-19 Regular Meeting
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Last modified
10/28/2019 1:00:16 PM
Creation date
10/28/2019 12:58:10 PM
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Admin-Clerk
Document Type
Minutes
Committee
Board of Commissioners
Date
8/19/2019
Book No
30
Page No
955
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EXHIBIT A <br />BENEFITS WAIVER FOR ASSIGNED EMPLOYEES <br />AGREEMENT AND WAIVER <br />In consideration of my assignment to Client by Staffing Firm, I agree that I am solely an <br />employee of Staffing Firm for benefits plan purposes and that I am eligible only for such benefits <br />as Staffing Firm may offer to me as its employee. I further understand and agree that I am not <br />eligible for or entitled to participate in or make any claim upon any benefit plan, policy, or <br />practice offered by Client, its parents, affiliates, subsidiaries, or successors to any of their direct <br />employees, regardless of the length of my assignment to Client by Staffing Firm and regardless <br />of whether I am held to be a common-law employee of Client for any purpose; and therefore, <br />with full knowledge and understanding, I hereby expressly waive any claim or right that I may <br />have, nor or in the future, to such benefits and agree not to make any claim for such benefits. <br />EMPLOYEE WITNESS <br />Signature Signature <br />Printed Name Printed Name <br />Date Date <br />7 <br />
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