Please print form below and mail or fax copies to: CLEAR, 403 Marquis Ave, Ste. 100, Lexington, Kentucky 40502. Fax: (859)231-1943
CLEAR CONSULTING SERVICE (CCS) CONSULTANT AGREEMENT
I, ________________________________ , do agree to assist the Council on Licensure,
Enforcement and Regulation (CLEAR) by serving as a (state type of)
____________________consultant to the _________________________ project for _____ days @ $300 per day.
I specifically agree to provide the following services and products between the dates of
____________________ and ___________________________, in accordance with the
attached documents and in exchange for satisfactory completion of which I will receive the
per-day consultant fee and reimbursement of pre-approved expenses: (Examples of services and
products to list : on-site visit, objectives and dates; specific report writing assignments)
Attachments List:
1.
2.
3.
4.
I understand that I will be reviewing or writing confidential material and do agree to NOT disclose
its contents or to compromise its security in any way. I further agree that I have been engaged as
an independent contractor and not as a representative of any organization I may otherwise
represent. I will immediately notify CLEAR and remove myself from participation on this project
should a breach of this agreement occur.
_____________________________ ________________________
Signature of Consultant Date
Accepted by CLEAR:
_____________________________ ________________________
CLEAR Staff Project Director Date