Effective September 17, 2026
THIS STATEMENT OF SERVICES IS MADE BY AND BETWEEN {{ employer_org_name}} (HEREINAFTER “COMPANY”) AND {{ agency_org_name }} (HEREINAFTER “STAFFING FIRM”) AS AN ADDENDUM TO THE TEMP TERMS MUTUALLY AGREED UPON BY BOTH PARTIES ON THE RECRUITIFI PLATFORM. AGREEMENT TO THIS STATEMENT OF SERVICES SHALL BIND THE COMPANY AND THE STAFFING FIRM TO EACH OTHER DIRECTLY BY THE TEMP TERMS IN ADDITION TO THIS STATEMENT OF SERVICES. ANY CONDITIONS FROM THE TEMP TERMS, AS WELL AS THE USE OF ANY CAPITALIZED TERMS OR OTHER DEFINITIONS FROM THE TEMP TERMS SHALL APPLY TO THIS STATEMENT OF SERVICES.
Whereas the Staffing Firm is engaged to act as the Employer of Record for a Resource on behalf of the Company, the parties agree as follows:
1. RESOURCE ENGAGEMENT
1.1 Details of the Engagement
The Staffing Firm agrees to act as the Employer of Record for the Resource listed below:
Resource Name:
Resource Email:
Resource Phone:
Title:
Work Location:
Expected Start Date:
Expected End Date:
Time Sheet Approvers At Signing:
Scope of the Position:
1.2 Rates
The engagement shall be billed and paid in accordance with the pricing model selected below. Non-selected pricing models are denoted as not applicable (“N/A”).
1.2.1 Bill Rate Pricing
The “Bill Rate” is a rate determined to be the standard hourly amount paid by the Company to the Staffing Firm for the engagement of a Resource. Under Bill Rate pricing, a standard hourly Bill Rate is established, and all payments such as overtime payments and the Staffing Firm “Earn Rates” (the amount paid to the Staffing Firm after any fees withheld) are based on this Bill Rate.
Standard Hourly Bill Rate:
Standard Hourly Staffing Firm Earn Rate:
1.2.2 Markup-Based Pricing
The “Pay Rate” is a rate determined to the standard hourly amount that will be paid to the Resource for their engagement. Under markup-based pricing, the Bill Rate is determined by establishing the standard Pay Rate and multiplying and adding a markup calculated using the Staffing Firm markup percentage below. Additional pay rates may not be listed here as they may vary based on many factors specific to the location and individual circumstances of the role.
Standard Hourly Pay Rate:
Staffing Firm Markup Percentage:
Markup Standard Hourly Bill Rate:
Markup Standard Hourly Staffing Firm Earn Rate:
1.2.3 Overtime Rates
Overtime rates may be determined based on either of the pricing models above. Overtime rates may not be listed here as they may vary based on many factors specific to the location and individual circumstances of the role.
Hourly Overtime Bill Rate:
Hourly Overtime Earn Rate:
Hourly Double Time Bill Rate:
Hourly Double Time Earn Rate:
1.3 Changes to the Engagement
Any material changes to this Statement Of Services must be executed under a new Statement Of Services.
2. CONVERSION
2.1 Conversion Fee Schedule
In the event that Company hires the Resource directly onto its own payroll or engages the Resource as an independent contractor (“Conversion”), Company shall pay RecruitiFi a Conversion fee in an amount calculated as a percentage of Resource’s new annual salary with the Company, as consistent with the following schedule:
2.2 Conversion Process and Calculation
Any Conversion must be done in the RecruitiFi Platform. The Conversion fee will be calculated based on the salary input into the RecruitiFi Platform during the Conversion process. The Expected Base Salary on Conversion listed in Section 1.1 is for estimation purposes only. Company is not obligated to pay according to this estimation, and it will not be used to calculate Conversion fees.
Conversion fees will be calculated in the following way. Based on the Time in Contract listed in Section 2.1, Column A, a corresponding Conversion percentage from Section 2.1, Column B will be selected. The Conversion fee will be the first year salary, input into the RecruitiFi Platform at the time of Conversion, multiplied by the appropriate Conversion Fee Percentage. The first year salary shall be the Resource’s initial annual base salary rate only, and shall not include any starting bonus, performance bonus, profit sharing, benefits, expenses, commissions or any other additional form of compensation or remuneration.
3 INSURANCE
3.1 Required Staffing Firm Coverage
Staffing will maintain the following levels of insurance at all times while acting as the employer of record for the Resource:
4 SIGNATURES
Signature from Staffing Firm Representative: __________________________
Signature from Company Representative: __________________________
