*Providing Quality Service To Satisfied Customers*

117 9th Street North • Columbus, MS 39701
2721 Sixth Street • Tuscaloosa, AL 35401
525 South Church Street • Tupelo, MS 38804
EMPLOYEE COMPLETE
ASSIGNMENT COMPLETED? YES NO
AVAILABLE FOR WORK? YES NO    WHEN _____________________________________
(IF AVAILABILITY NOT INDICATED, KEY MAY ASSUME I AM NOT AVAILABLE)

UNLESS NOTED BELOW, I HAVE NOT BEEN INJURED ON THE JOB THIS WEEK
NOTE ______________________________________
EMPLOYEE SIGNATURE ___________________________________________
CLIENT PLEASE COMPLETE
Name of Company ____________________________________________
Authorized Signature ____________________________________________
(Includes acceptance of terms and conditions on reverse)

Printed Authorized Name ____________________________________________
IMPORTANT FOR CLIENT. BY EXECUTION OF THIS FORM. CLIENT CERTIFIES THAT HOURS SHOWN ARE CORRECT. WORK WAS SATISFACTORY AND THAT CLIENT AGREES TO THE TERMS AND CONDITIONS ON THE REVERSE SIDE OF THIS FORM.
Four (4) hour min. per person per day. Please do not advance money to employee. EOE/M/F/H
   EMPLOYEE (FIRST) NAME (LAST)
 
SOCIAL SECURITY NUMBER WEEK ENDING DATE
                       
SPECIAL
EMPLOYEE
INSTRUCTIONS
1. This slip must be filled in completely and accurately.
2. Be sure to leave the client one copy.
3. Sign and mail immediately upon completion of assignment, at the end of each week, or bring to Key.
4. Fill in Total Hours
TOTAL HOURS FOR THE WEEK
(To Nearest 1/4 Hour)
TOTAL HOURSOVERTIME HOURS
  
  MON. TUES. WED. THURS. FRI. SAT. SUN.
HRS MIN HRS MIN HRS MIN HRS MIN HRS MIN HRS MIN HRS MIN
TIME IN                            
LUNCH OUT                            
TIME OUT                            
TOTAL
STR. TIME
                           
TOTAL
OVERTIME
                           

CLIENT AGREEMENT
Key Staff Source (hereinafter called "Key"), agrees to provide the Customer with a temporary employee or employees (hereinafter employee). Customer, in consideration for Key furnishing the temporary employee, agrees to the following:
     (1) Customer certifies and warrants that the hours on the reverse side of this card are correct and the employee performed all duties in a satisfactory manner.
     (2) Customer agrees not to employ or cause others to employ the temporary employee(s) named herein except through Key's office. if customer should desire to hire a Key employee, the employee must first work a total of 480 hours. if the employee has worked less that 480 hours, Customer agrees to pay an early release buyout fee. The early release buyout fee is non-refundable.
     (3) If the Customer places an order for a temporary employee and the employee arrives at the work site but is not used by the Customer then the customer will be billed a minimum for four(4) hours.
     (4) the Customer agrees that it will not authorize or direct or cause any Key temporary employee to operate machinery, motor vehicle or any other kind of type of mechanical or electrical equipment whatsoever(hereafter "equipment"), not specified in the original work order, without prior written consent of Key. In all circumstances, the Customer assumes responsibility and liability for physical loss or bodily injury and any and all other damage of any type or kind that bay be caused by the operation of any equipment by a Key employee. The Customer further agrees to indemnify, defend and hold harmless Key from any and all claims, actions, causes of action, legal proceedings and expense or costs, including attorney's geed incurred, which may be instituted or asserted against Key as a result of any claim or cause of action arising as a result of or in anyway connected with the operation of such equipment by a Key employee.
     (5) The Customer agrees that it shall not entrust any Key temporary employee with cash, negotiable instruments or other valuables, without prior written consent from Key. In the event the Customer does entrust a Key temporary employee with cash, negotiable instruments or other valuables, without Key's prior written consent, then the Customer agrees that it shall bear sole responsibility and liability for any loss and/or damage that might occur.
     (6) Customer agrees to indemnify, defend and hold Key harmless from any and all claims, actions, causes of action, legal proceedings and expense or costs, including attorney's fees incurred, which hereafter be instituted or asserted against Key as a result of any claim or cause of action arising our of or in any way connected with the Occupational Safety and Health Act as it relates to the premises owned, rented or controlled by the Customer, or to which the temporary employee is assigned or directed, and as to any and all laws, regulations, and/or orders relation to equal employment opportunity.
     (7) The Customer agrees that it will pay a finance charge at the rate of 1.5% per month (18% per annum), on any charges remaining unpaid thirty (30) days after invoice date, and any and all other costs or expense of collection incurring to collect charges remaining unpaid thirty (30) days after the invoice date, including reasonable attorney's fees.