INDEPENDENT SERVICE PROVIDER CONTRACT (ISP)

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1 INDEPENDENT SERVICE PROVIDER CONTRACT (ISP) INSTRUCTIONS FOR USE: The purpose of this form is to be used for contracts with individuals engaged in technical, professional or specialized skills such as guest speakers, athletic officials, consultants, performers and to request honorarium payments to individuals who: Provide one-time nonrecurring services. Are to be paid $ or less (no receipts required, all payments reportable as taxable income); and Who are not otherwise employed by the Nevada System of Higher Education (which includes CCSN, DRI, and GBC, TMCC, UNLV, UNR, WNCC, or NSHE System Administration. Payment exceeding $ and/or travel expenses are to be reimbursed after completing the engagement. Please see instructions to submit a UNLV Independent Contractor Agreement (ICA) for payments over $ Before the ISP contract is initiated ISP status must be determined: Complete the Evaluation for Determining Independent Service Provider Status (page two of this package). If an individual is neither a U.S. Citizen nor a lawful permanent resident (green card holder). Additional documents may be required, please see the last page of this package for additional information and contact the Assistant Controller for Accounts Payable at before proceeding with this ISP document. When negotiating this one time payment, determine if the payment will consist of a fee as well as travel expenses; remember the total of the contract MAY NOT EXCEED $ Although recommended a traveler make his/her own travel arrangements, the department may prepay certain travel expenses, such as lodging, vehicle rental and airfare. Best Practice Example: Traveler to make own arrangements: Total cost to the department and payable to the traveler = $ the check may be available during the visit if requested. Alternative Example: Traveler with university prepaid arrangements: $ fee + $45.50 for two days of meals, less one hosted lunch+ $ for Airfare prepaid by P-card, + $ for one day of lodging prepaid by P-card: Total department cost = $ hosted meal. Payable to Traveler = $ after the trip has ended. If meals and lodging are included in your contract negotiation, the daily allowance is $45.00 If any hosted meal is anticipated, the meal allowance for that meal must not be considered in the allowance for that day. In State or Outside the state, regardless of funding, use the GSA table to determine meal and lodging allowances. Shortcut: Use the table to determine the rate in which the traveler is entitled to receive, print and keep for your records. Please make note that the first & last day of travel are only reimbursable at 75% of the M&IE, regardless of departure times. Prepayment method - For travel expenses in cases were the payment to the individual is $ or less, and you would like to offer transportation and lodging: Lodging and Rental Vehicles may be prepaid by P-Card; Lodging may also be prepaid by UNLV by method of a payment voucher accompanied by the hotels confirmation of the reservation. Airfare may be prepaid by method of P-card or the Travel Authorization Form. S:\Accounts Payable\Forms\Travel Authorization Form.pdf Once you have determined the status of the payee to be a true ISP and negotiated the contract: Complete and submit the signed ISP contract, a signed W-9 (if a U.S. Citizen or W-8BEN (if international), the Evaluation for determining ISP status, a flyer announcing the engagement, invitation letter or complete the exhibits page included in this package. Submit the completed package to the Controller s Office, Accounts Payable mail stop DO NOT SEND THIS SHEET TO THE CONTRACTOR; KEEP FOR YOUR REFERENCE. SEND ONLY APPLICABLE PAGES TO THE CONTRACTOR. FAX SIGNATURES ARE ACCEPTED.

2 Evaluation for Determining Independent Contractor Status Hiring departments are responsible for providing information to properly classify individuals as employees or independent contractors. The following questions are intended to measure the extent of control which the University/NSHE may exercise over the worker. Generally, if there is a good deal of control over what the worker does and how the worker does the work, there should be an employee relationship established (EDOC). If there are few elements of control, an independent contractor relationship may be appropriate. Yes No 1. Must the service provider follow substantial instructions? If yes, describe the Type of direction and control and who will supervise the services: 2. Are substantive training, guidance, and/or assistance provided to the contractor? 3. Is the contractor s job substantively integrated in the general operation of the Department/University/NSHE? 4. Are services rendered personally by the contractor? 5. Does the contractor hire, supervise, and pay assistant workers? 6. Does the arrangement contemplate continuing or recurring work? If yes, explain: 7. Does the University/NSHE establish set hours of work? 8. Is there a full time requirement? 9. Will the service be performed on the University/NSHE premises? 10. Does the University/NSHE require that the work be done in a specific order or sequence? 11. Is regular accountability required? 12. Is payment by the hour/week/month as opposed to payment by the task/job completed? 13. Does the University/NSHE furnish equipment, tools or supplies to the contractor? 14. Can the contractor be discharged even if the contract terms are being met? 15. Does the contractor have the right to terminate without contract liability? 16. Is NSHE the only client for whom these or similar services are actively provided? 17. Has the contractor performed this or other services for the University/NSHE in the past? If yes; when 18. Will business and travel expenses be the departments responsibility? 19. Will the department provide or invest in supplies and or equipment? 20. Will the individual depend solely on this contract for personal invoice?

3 ISP# Vendor # INDEPENDENT SERVICE PROVIDER CONTRACT (ISP) Payee Information All information is required (including answering questions A-C below): Service Provider Payment Information: FULL NAME Last Name (Please Print or Type) MI First Name U.S. TIN/Social Security Number Payee must complete Form W-9 (if a U.S. Citizen) or W-8BEN (if International) Engagement Date(s) to MM/DD/YY MM/DD/YY Total Payment Amount $ Check Due Date (Not to exceed $2000 use ICA if above this amount) (Not before end date) Mailing Address (number) (PO Boxes are not accepted) City State Zip A) Is the payee a current or former (within the current calendar year) employee of any institution of the Nevada System of Higher Education? If the answer to question A is yes, do not proceed with this form. Process the payment on an employment document. Yes No B) Is the payee a member of the same household as a NSHE employee? If the answer to question B is yes, do not proceed with this form. Under the Board of Regents Conflict of Interest policy (B/R Handbook, Title 4, Chapter 10), payment is not allowed. Yes No C) Is the payee a U.S. citizen or lawful permanent resident (green card holder)? If the answer to question C is no, contact the Assistant Controller for A/P. See information regarding U.S. tax information for Nonresident Alien Consultants and Guest Speakers. Yes No ACCOUNT INFORMATION:

4 FUND AGCY ORGN OBJT SOBJ AMOUNT Disposition of check if not to be mailed to the payee s address: TOTAL Call for pickup: Notes: The Nevada System of Higher Education is an equal opportunity/affirmative action employer and does not discriminate on the basis of race, color, religion, sex, age, creed, national origin, veteran status, or physical or mental disability in any program or activity it operates. The NSHE employs only United States citizens and individuals lawfully authorized to work in the U.S. Payee must complete and attached Form W-9 (if a U.S. citizen/resident) or W-8BEN (if international) PAYMENT AUTHORIZATION: Based on the above, It is my determination that the payee meets the guidelines for one-time, nonrecurring payment. AGREEMENT: I have read and agree to the above representations and assert that they are true and correct. Authorized Accounts Signature Date Payee Signature Date Printed Name of Authorized Signer Mailing Address (PO Boxes are not accepted) Department Mail Stop City State Zip Department Contact Phone Number Fax Number Telephone Number Fax Number address CONTROLLERS OFFICE REVIEW By: Date:

5 Contract Exhibits A, B and C. ISP # Exhibit A. Explain in detail what the contractor will do specifically what will be done by the contractor, where the work will be accomplished, and when the work will be completed). Exhibit B. Indicate the total amount of payment and the date when the payment will be made. The date the payment will be made should be the ending date of this contract. Exhibit C. List any special conditions that apply.

6 Payments are subject to1099 or 1042-S (if a nonresident alien) reporting guidelines.

7 U.S. TAX INFORMATION FOR NONRESIDENT ALIEN CONSULTANTS AND GUEST SPEAKERS The Internal Revenue Service (IRS), the U.S. government tax authority, has issued strict regulations regarding the taxation and reporting of payments made to non-united States citizens. As a result, the University and Nevada System of Higher Education ( NSHE ) may required to withhold U.S. income tax and file reports with the IRS in connection with payments made by the NSHE to consultants and guest speakers who are not U.S. citizens or permanent resident aliens (greencard holders) and who receive compensation for services performed and/or reimbursement for travel. The NSHE must determine whether you will be treated as a resident alien or nonresident alien for U.S. tax purposes. Consultants or guest speakers who enter the U.S. under a visitor s visa (e.g., B-1 or B-2) or a waiver of a visa (e.g., WB or WT) are generally treated as nonresident aliens if they are present in the U.S. for a total of less than six months over a three year period. Consultants or guest speakers who are present in the U.S. under a J-1 visa are usually considered nonresident aliens for the first two calendar years that they are present in the U.S. The NSHE is generally required to withhold taxes for all payments made to nonresident aliens. In order for the NSHE to make a correct determination about tax withholding, all guest speakers who are not citizens or permanent resident aliens of the U.S. must complete the Alien Information Collection Form and return it to the NSHE department that issued the initiation to speak. Once your U.S. tax status has been determined, if you are a nonresident alien, a tax equal to 30 percent is generally required to be withheld. Taxable items include, but are not limited to: Honoraria Consulting Fee Compensation Speaker Fee Living Allowance Cash Award The U.S. maintains income tax treaties with over 50 countries, and certain taxable payments made by the NSHE to you may be exempt from U.S. tax based on an income tax treaty entered into between the U.S. and your home county. The existence of a tax treaty does not automatically ensure an exemption from taxation; rather, you must satisfy the requirements for the exemption set forth in the tax treaty. In order to be considered for a tax treaty exemption, you must complete Form You must complete Form 8233 and return it via facsimile or post to the NSHE department that invited you to speak. A 30 percent withholding tax will be deducted from compensation payments made to consultants or guest speakers (i) who are from countries that do not maintain an income tax treaty with the U.S., (ii) whose payment does not qualify for exemption under a tax treaty, or (iii) who does not complete Form 8233 in a timely manner. If From 8233 is submitted after the NSHE has deducted tax from a payment to you, the NSHE cannot refund the tax to you; you must file a U.S. income tax return at year-end to apply for a refund of tax withheld from the IRS. Please note that the NSHE is also required by law to report to the IRS all payments made to a nonresident alien, or a third party on his or her behalf, regardless of whether the payment is subject to U.S. tax. All individuals who receive payment from the NSHE are also required by law to disclose their U.S. social security or individual taxpayer identification number, he or she is required to complete From W-7 and submit the form and supporting documentation in person to the Assistance Controller for the Accounts Payable Department. All consultants and guest speakers who are not citizens or permanent resident aliens of the U.S. are required to complete tax information forms prior to receiving any payment. If you have additional questions about how to complete the required forms or need information concerning tax-withholding obligations, please contact the Assistance Controller for the Accounts Payable Department at

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