Third-Party Contractor Agreement Form

Third-Party Contractor Agreement Form

Please read the full terms of engaging Happy Valley Home Care Pty Ltd services through Trilogy Care. This form will be automatically emailed to Happy Valley Home Care once you accept and sign. A copy will be emailed to you for your records.
Background

The Contractor acknowledges that the Consumer is entitled to receive the Services under a client agreement with Trilogy Care Pty Ltd ABN 44 604 915 200 (Trilogy Care), a registered provider under the Aged Care Act 2024 (Cth) (Aged Care Act).
The Consumer has sourced, interviewed and has made the decision to engage the Contractor directly to deliver the Services to the Consumer on the terms of this Agreement.
This Agreement sets out the basis on which the Consumer will engage the Contractor to deliver the Services, and Trilogy Care will make payment on behalf of the Consumer from the Consumer’s available government subsidies. The Contractor and Consumer acknowledge that, while Trilogy Care is not a party to this Agreement, the provisions which involve Trilogy Care are necessary to ensure that the Services are delivered in accordance with Trilogy Care’s obligations to the Consumer and under the Aged Care Act.
Contractor Details
Contractor Name

Happy Valley Home Care Pty Ltd
Contractor ABN

75 656 643 640
Contractor Mailing Address

2/50 Main Street Croydon VIC 3136
Contractor Phone Number

03 8740 3236
Contractor Email Address

services@happyvalleyhomecare.com.au
Consumer Details
Consumer Name

First NameMiddle NameLast Name
Consumer Mailing Address

Street Address (please add unit numbers if you have one)

Street Address Line 2
CityStatePostcode
Consumer Phone Number
Please enter a valid mobile or landline number Format: (000) 000-0000.
Consumer Email
example@example.com
Consumer Representative Details
Consumer Representative Name

First NameMiddle NameLast Name
Consumer Representative Mailing Address

Street Address

Street Address Line 2
CityStatePostcode
Consumer Representative Phone Number
Please enter a valid mobile or landline numberFormat: (000) 000-0000.
Consumer Representative Email
example@example.com
Services

Happy Valley Home Care offer the following services: Domestic Assistance - cleaning, shopping, laundry & meal preparation, Social Support, Respite, Transport and Personal Care.
Length
Frequency
Transport or Travel services required
Location of Services

Clients home
Service Fees

Please see Pricing section
Contractor Qualifications

As per Contractor Agreement with Trilogy Care and the Aged Care Act 2024
Provision and Engagement Conditions
Engagement by Care Administrator and Coordinator
Engagement by Care Administrator and Coordinator Details
Consumer / Authorised Agent Signature
Consumer / Authorised Agent Name
Consumer / Authorised Agent Relation
Consumer / Authorised Agent Signature
Consumer / Authorised Agent Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate