I the undersigned owner of Client Company below hereby certifies that the Client Company is reporting
ZERO
WAGES for the Pay Period noted below, referred to commonly as an Inactivity Week of which I will pay a
fee
of $150 as per the Professional Employer Service Agreement.
Client Company affirms to COMPEO that it has NOT performed any of the following, directly or indirectly,
during the Pay Period noted below:
- Employed and/or paid in any manner any persons acting as an employee and has ZERO payroll to
report.
- Performed any work warranting payment or any compensation to any persons or employees.
- Performed any work for COMPEO certificate holders, or implied workers compensation coverage under
the COMPEO Professional Employer Service Agreement.
Further, I and Client Company hereby agree to release and hold harmless COMPEO and its respective
affiliated companies, officers, directors, agents, employees, and insurance carriers from, and to
indemnity
each of them against any and all liabilities, obligations, contractual or otherwise, claims and causes
of
action for renumeration, injury, death, disease, or employer liability arising from or in connection or
arising during the Pay Period noted below.
This hold harmless and indemnification includes, but is not limited to any and all (I) workers
compensation
coverages or liabilities, (II) employment related requirements or liabilities, (III) employment related
taxes or required filings, and/or (IV) obligations under the Professional Employer Service
Agreement.
Under penalty of perjury, I certify that the information presented in this affidavit is true and
accurate.
I
the undersigned further understands that providing false representations herein constitutes an act of
fraud.
False, misleading or incomplete information may result in the termination of the Professional Employer
Service Agreement and any remedies at law or equity.
