1. Financial Authorization: By signing this agreement, I,
the undersigned, acting on behalf of the business entity specified in this application,
hereby authorize QuickCare Employer Solutions LLC to initiate ACH debit entries and/or
credit card charges to the financial account(s) indicated in this application for the
purpose of paying for services rendered. This authorization remains in full force and
effect until QuickCare Employer Solutions LLC receives written notification of its
termination in such time and manner as to afford QuickCare Employer Solutions LLC and
the financial institution reasonable opportunity to act upon it.
2. Service Terms: I agree that QuickCare Employer Solutions
LLC will provide occupational health services as outlined in this application. I
understand that service availability may vary based on location and specific business
needs. QuickCare Employer Solutions LLC reserves the right to modify service offerings
with reasonable notice.
3. Data Handling and Privacy: I acknowledge that QuickCare
Employer Solutions LLC will collect, store, and process business and employee data as
necessary to provide the agreed-upon services. QuickCare Employer Solutions LLC commits
to handling all data in accordance with applicable privacy laws and regulations.
4. Compliance: I confirm that the information provided in
this application is true and accurate to the best of my knowledge. I agree to comply
with all relevant health and safety regulations and to cooperate with QuickCare Employer
Solutions LLC in maintaining a safe work environment.
5. Termination: Either party may terminate this agreement
with 30 days written notice. Any outstanding fees for services rendered will be due upon
termination.
6. Liability: QuickCare Employer Solutions LLC's liability under this
agreement shall be limited to the cost of services provided. QuickCare Employer
Solutions LLC is not liable for any indirect, incidental, or consequential damages.