Depaul University Honorarium Agreement

Please see table below to determine which Honorarium Agreement is appropriate:

Service Provider is a U.S Person/Citizen / Service Provider is a Non-U.S. Person/Citizen
Services performed insidethe U.S. / Use this Agreement / Use this Agreement
Services performed outside the U.S. / Use this Agreement / Use the “DePaul University International Honorarium Agreement for Individuals”

DePaul University Honorarium Agreement for Individuals

This DePaul University Honorarium Agreement (“Agreement”) is entered into by and between DePaul University (“DePaul”), an Illinois not-for-profit corporation with headquarters in Chicago, Illinois, and Speaker,named below.

Speaker Name(required): / Speaker Home Address(required):
Speaker SSN/ITIN:
(required if number has been issued by the Social Security Administration or Internal Revenue Service) / Speaker Phone Number:
Speaker Email Address:

1.Payment. DePaul agrees to pay Speaker (check and fill-in all items that apply):

An honorarium payment of $ within days after Speaker completes his or her Services.

One round-trip coach airline ticket from to Chicago, Illinois.

Hotel accommodations at hotel in Chicago, Illinois, for a total of room nights.

Additional items or notes (if any):

2.Services. Speaker agrees to performthe following Services:

Topic/Presentation Title:

Date/Time/Duration:

Location:

Additional notes (if any):

3.Relationship. Speaker is anindependent contractor and not an employee, agent, joint venturer or partner of DePaul. Speaker assumes full and sole responsibility for the payment of his or her state and federal income tax, unemployment insurance, social security, disability insurance and other taxes, fees or costs resulting from compensation under this Agreement. Speaker represents and warrants that Speaker is authorized to work in the U.S. for purposes of performing the Services.

4.Copyright and Licensing. Speaker does or does not give DePaul rights to record the Services in audio, video and photographic format and to reproduce, distribute, and/or publicly display such recording(s), electronically or in print, for educational or non-commercial purposes.

5.Indemnification. Speaker shall, at all times after the date of this Agreement, indemnify, defend, and hold harmless DePaul and DePaul’s trustees, directors, officers, faculty, employees, affiliates, and agents, past or present against all losses, claims, demands, actions, causes of action, suits, liabilities, damages, expenses, and fees (including reasonable attorneys’ fees) arising out of or relating to any actual or alleged (i) misrepresentation, breach of warranty, breach of promise, or breach of covenant by Speakerof any representation, warranty, promise, or covenant in this Agreement; (ii) personal injury or property damage caused, in whole or in part, by the acts, errors or omissions of Speaker arising out of or related to Speaker’s Services; and (iii) infringement by Speaker of any third party’s patent, trademark or copyright.

6.Miscellaneous. Speaker shall not be entitled to any compensation in the event of a failure or refusal to perform the Services, whether due to illness, accident or otherwise. This Agreement embodies the entire understanding between the parties and may not be amended or changed in any way except by a written instrument signed by both parties. This Agreement may not be assigned without the written consent of the non-assigning party. This Agreement shall be governed in all respects by the laws of the State of Illinois. The parties to this Agreement agree to use the State of Illinois for jurisdiction and the County of Cook as venue for any disputes between the parties.

7.Tax Information. Speakerisoris not a U.S.Citizen or Resident Alien for Tax Purposes.

To be completed by Speaker if Speaker is a U.S. Citizen or Resident Alien for Tax Purposes:
Please check appropriate box for federal tax classification:
Individual/Sole proprietor / C Corporation / S Corporation
Partnership / Trust/estate
Limited Liability Company.Enter the tax classification (C=C corporation, S=S corporation, P=partnership)
Other (see Form W-9 instructions on IRS website)
Exemptions (see Form W-9 instructions on IRS website):
Exempt payee code (if any): N/A / Exemption from FATCA reporting code (if any): N/A
Substitute W-9 Certification (for United States citizens and resident aliens for tax purposes):
Under penalty of perjury, I certify that:

The number shown on this Agreement is my correct social security number/taxpayer identification number (or I am waiting for a number to be issued to me), and
I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding, and
I am a U.S. citizen or other U.S. person (defined in the Form W-9 Instructions on IRS website) , and
The FATCA code(s) entered on this Agreement (if any) indicating that I am exempt from FATCA reporting is correct.

Note: You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you failed to report all interest and dividends on your tax return.
The IRS does not require your consent to any provisions of this document other than the certifications required to avoid backup withholding.
Signature: Date:
By:
For Non-U.S. Citizens and Non-Resident Aliens for Tax Purposes:
Speaker represents that he/she is not a United States citizen, resident alien or other United States person for tax purposes, and agrees to complete and submit DePaul’s International Information Form and any required tax forms. Speaker further represents and warrants that he/she has not received, nor does he/she anticipate receiving, more than four (4) additional like payments or reimbursements from other educational or research institutions within a six-month period. Speaker will not perform activities in excess of nine (9) days in conjunction with the above described Services.

SO AGREED,

DEPAUL UNIVERSITY / SPEAKER
Signature: / Signature:
Printed Name: / Printed Name:
Title: / Title:
Date:
Extension: / Date:

UTS Rev. 06.27.14DePaul University Honorarium Agreement for Individual – Page 1 of 3