Employment Application

I, THE UNDERSIGNED EMPLOYEE, IN CONSIDERATION OF MY HIRING BY MyPEO AS AN AT-WILL LEASED EMPLOYEE OF MyPEO, ACKNOWLEDGE AND AGREE TO THE FOLLOWING:

1. I have been hired as an at-will employee of MyPEO, which is an employee leasing company that is the employer of record and provides payroll administration, workman’s compensation coverage, and year end W-2 statements.
2. I understand I am a leased employee.
3. There is no contract of employment which exists between me and the Client to which I have been assigned; nor between MyPEO and me, and MyPEO have no liability with regard to any employment agreement.
4. I understand and agree that either MyPEO or I can terminate our employment relationship at any time as I am an at-will employee of MyPEO.
5. I further understand and agree that continued employment with the Client to which I have been assigned is an essential requirement for employment with MyPEO, and that if my employment with the Client to which I have been assigned ends, my employment with MyPEO will also immediately end at that time.
6. I also agree that while I am a leased employee of MyPEO, if MyPEO does not receive payment from Client for services which I perform as a leased employee, MyPEO will still pay me the applicable minimum wage (or the legally required minimum salary) for any such pay period, and I agree to this method of compensation.
7. I understand and agree that MyPEO has no obligation to pay me any other compensation or benefit unless MyPEO has specifically, in a written agreement with me, adopted the Client’s obligation to pay me such compensation or benefit.
8. I understand that the Client to which I am assigned at all times remains obligated to pay me my regular hourly rate of pay if I am a non-exempt employee, and to pay me my full salary if I am an exempt employee, even if MyPEO is not paid by the Client to which I am assigned.
9. I understand and agree that MyPEO does not assume responsibility for payment of bonuses, commissions, severance pay, deferred compensation, profit sharing, vacation, sick, or other paid time off pay, or for any other payment, where payment for such items has not been received by MyPEO from the Client to which I am assigned.
10. In recognition of the fact that any work-related injuries which might be sustained by me are covered by state workers' compensation statutes, and to avoid the circumvention of such state statutes which may result from suits against the customers or clients of MyPEO, or against MyPEO based on the same injury or injuries, and to the extent permitted by law, I hereby waive and forever release any rights I might have to make claims or bring suit against any client or customer of MyPEO or against MyPEO for damages based upon injuries which are covered under such workers' compensation statutes.
11. I also agree to comply with any drug testing policy which MyPEO may adopt, and I specifically agree to post-accident drug testing in any situation where it is allowed by law.
12. In addition, I also agree that if at any time during my employment I am subjected to any type of discrimination, including discrimination because of race, sex, age, genetic information, religion, color, retaliation, national origin, handicap, disability, or marital status, or if I am subjected to any type of harassment including sexual harassment, I will immediately contact an appropriate person of the Client Company to which I have been assigned. In most instances, this appropriate person will be the president of the Client Company. Should I choose not to contact the Client Company for any reason, I may contact MyPEO Human Resources Director at 850-696-2966 in order to obtain assistance in the resolution of such matters. I understand and agree MyPEO does not have actual control over my workplace and as such, is not in a position to end or remediate any discrimination, harassment, or retaliation which may be occurring. The responsibility to resolve and/or end such inappropriate conduct rests with the Client Company; however, MyPEO will attempt to facilitate a resolution.
13. I understand and agree that if I am accepted as a leased employee of MyPEO, I am expressly prohibited from performing any work outside the state of Florida for Client during my status as a leased employee except as is allowed pursuant to the workers’ compensation policy provided to me by MyPEO, or except as may be allowed in writing by MyPEO and MyPEO workers’ compensation carrier. If I work outside the state of Florida for client without first securing this approval, I understand that I will not be a leased employee of MyPEO and may not be provided workers’ compensation benefits through MyPEO or MyPEO’s workers’ compensation carrier. My leased employment with MyPEO will be considered immediately terminated upon commencement of my trip outside the state of Florida to perform work for client where prior approval has not been received as set forth herein.
14. Upon separation from employment, I understand that I must call MyPEO at 850-696-2966.  I understand that if I make no attempt to contact MyPEO benefits may be denied.

As a MyPEO employee, your safety is our greatest concern. For that reason, there are certain jobs and working conditions that we do not allow. Under no circumstances do we allow our workers to get on roofs.

Work that is more than six feet off of the ground must be approved by MyPEO in writing, and work that is more than knee level below ground must meet OSHA requirements. If you are ever asked to perform work that involves these conditions, you must call our office immediately at 850-696-2966.

NO ROOFS!

NO WORK MORE THAN SIX FEET OFF OF THE GROUND WITHOUT WRITTEN CONSENT FROM MyPEO.

DO NOT PERFORM ANY WORK THAT YOU FEEL IS UNSAFE!

By signing below, I agree to call MyPEO’s office if I am asked to perform work that requires me to get on a roof, is more than six feet off of the ground, or is more than knee deep below ground level.

Workers’ compensation fraud occurs when any person knowingly and with intent to injure, defraud or deceive any employer or employee, insurance carrier or self-insured program, files false or misleading information. Workers’ compensation fraud is a third-degree felony that can result in fines, civil liability and jail time. Rewards of up to $25,000 may be paid to individuals who provide information that lead to the arrest and conviction of persons committing insurance fraud.

To report suspected workers’ compensation fraud call 850-696-2966

1. I hereby authorize MyPEO to initiate credit entries and to initiate, if necessary, debit entries and adjustments for any credit in error on my account indicated below and the depository named below to credit and/or debit the same to such account.
2. This authority is to remain in full force and effect until MyPEO has received written notification from me of its termination in such time and such manner as to afford MyPEO and a depository a reasonable opportunity to act on it. I realize that MyPEO is not responsible for any deposits that are not in my account by my regular payday. I further realize that depending on my bank, a deposit that MyPEO has initiated may take up to three to five business days to affect my account.
3. Additionally, I understand that Direct Deposit will only begin after I have provided complete information requested on this form including a voided check or bank letter showing routing and account numbers.
4. I understand that my name must be on the bank account and if it is not, undetstand that the deposit may be rejected and all fees incurrec will be my responsibility.