Contract Placement Record

Consultant Name Consultant Name *ElaineColetteClaireKatieSophieCorieCiaran

Consultant Email Address (for confirmation email)

Terms of Business Signed: Terms of Business Signed: *YesNo

TOB saved to Client Contact / Jobs / Company Profile: TOB saved to Client Contact / Jobs / Company Profile: *YesNo

Has this company been credit checked? Has this company been credit checked? *YesNo

Has this company been sent the New Client Onboarding Form? Has this company been sent the New Client Onboarding Form? *YesNoNot applicable (existing client)

Company Name (ask client for correct company name to bill):

Name of Person to Invoice:

Direct Phone Line for Person to Invoice:

Is a PO required? Is a PO required? *YesNo

What is the PO Number (if required):

Is this company VAT exempt? Is this company VAT exempt? *YesNo

What is the VAT exemption number? (if applicable)

Further Invoice Required: Further Invoice Required: *YesNo

Billing Contact Email:

Billing Contact Phone Number (if known):

Candidate Name:

Candidate Position:

Start Date:

End Date (if applicable):

Percentage Rate Agreed:

Billable Fee:

Any Additional Information: