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Last Name |
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| Social Security Number |
Week ending Date(Sunday) |
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By signing this form, I agree that the hours listed were worked by me and were verified by the authorized employee of the customer and that no injuries were suffered by me. I understand I am to contact TempStaff after completing this assignment to discuss another assignment. If I do not do so, TempStaff can assume I am not available to work.
Employee Signature |
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Client Signature indicates acceptance of the terms and conditions below. Do not sign if hours are not totaled.
Authorized Signature |
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Time Started |
Time Finished |
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Total Hours |
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Total Hours for Work |
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| To be paid promptly, timecards must be received by 9:00 a.m. Monday. |
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P. O. Box 1654
Jackson, MS 39215
Office Support Division
(601) 353-4200
Industrial Division
(601) 353-3777
FAX (601) 714-4680
Record all times to the
nearest 15 minutes.
15 min. = .25
30 min. = .50
45 min. = .75
Four (4) Hours Minimum Per Employee Per Assignment |
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To: TempStaff Payroll Department
Fax: 601-714-4680
From: ___________________________________________________
Phone: ____________________________________________________
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Client Signature indicates acceptance of the following terms and conditions. Do not sign if hours are not totaled. The authorized signatory authenticates the TOTAL HOURS listed are correct, and that the work was performed in a satisfactory manner.
In consideration of the furnishing of services by TempStaff, it is agreed that the client, its subsidiaries, or affiliates shall not employee the person named on this timecard for a period of six (6) months following their completion of any assignment to the client. A breach of this agreement shall entitle TempStaff to recover liquidated damages. The liquidated damages shall be at the rate of 10% of the total annual compensation. In no instance shall the liquid damages be less than $1,500.
The client shall not entrust TempStaff employees with unattended premises, cash, negotiables and other valuables or authorize such employees to operate machinery or motor vehicles without first obtaining written consent from TempStaff in each instance.
It is acknowledged, understood and agreed that TempStaff insurance does not cover loss or damage caused by TempStaff employees operating client owned or leased motor vehicles. The client agrees to accept full responsibility for claims, including the defense thereof, involving the bodily injury, property damage, fire, theft, collision, cargo damage or public liability damage sustained or incurred as a result of a TempStaff employee driving such vehicles or arising out of or involving a violation by client.
Client shall indemnify and save TempStaff harmless from claims and demands arising out of the Occupational Safety and Health Act as it relates to premises owned or controlled by customer and to which TempStaff employees are assigned.
The client shall not advance cash or other valuable to TempStaff employees for any reason and the client specifically waives any and all rights to offset the amount or value of such cash or valuables advanced against any money owed to TempStaff. The client acknowledges his understanding that TempStaff invoices are for labor and therefore agrees to pay such invoices upon receipt.
In the event that TempStaff institutes legal action to recover any amount due TempStaff under agreement between TempStaff and client, in addition to other remedies, TempStaff shall be entitled to reasonable attorney’s fees, court costs and interest both before and after judgment at the rate of 18% per annum until payment in full.
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