Queensland Government

worker

Contingent Worker Consent Form

Recitals
A. The Contingent Worker (the Worker) is engaged by an entity (the Supplier) which provides contingent labour
services under a Queensland Government Standing Offer Arrangement (the Arrangement) with the State of
Queensland (‘the Principal’) to eligible customers as defined under that Arrangement (Customers1).
B. The Worker wishes the Supplier to put forward the Worker for temporary roles with Customers, from time to time.
C. In assessing whether to engage the Worker for temporary roles, Customers may require criminal history checks
to be conducted on the Worker (either by the Customers or by the Supplier on their behalf) and information
relating to the outcome of the criminal history checks to be shared with the Supplier.
D. During any engagement of the Worker to a temporary role with a Customer, the Customer will want to share
information related to the performance of the Worker with the Supplier, the Principal, other Customers and
relevant service providers to the Arrangement, including the vendor management system supplier and the
resource manager which manages the system.
E. To be considered for engagements for temporary roles with Customers, the Worker is required to provide the
consents set out below.

Contingent Worker Consent

I hereby,
• consent to Customers (or the Supplier on their behalf) undertaking criminal history checks in relation to roles for
which I wish to be put forward for consideration;
• consent to information2 related to the outcome of a criminal history check being shared between the Customer
which required the criminal history check and the Supplier;
• consent to information related to my performance in a temporary role with a Customer, should I be engaged in
that temporary role, being stored on the vendor management system3 which will be accessible by the Supplier,
the Principal, current and future Customers and relevant service providers to the Arrangement, including the
vendor management system supplier and the resource manager which manages the system, for the purposes of:
a) managing the procurement of services;
b) reviewing my performance under the engagement; and
c) assessing my suitability to perform services under any future contracts with Customers.

Contingent Worker Name Ram Kiran Pratap

Supplier Name Paxus

Contingent Worker Signature4

Date 13th June 2019

1 All of the following entities are eligible Customers under the relevant Queensland Government Contingent Labour SOAs:
(a) Queensland Government departments and agencies;
(b) Queensland Government Bodies;
(c) any entity which is directly or indirectly, partially or entirely funded by the State of Queensland, and/or a community based, non-profit making
organisation performing community services, and/or another entity, from time to time approved by the State of Queensland as an eligible
Customer under the SOA; and
(d) the Commonwealth, another State or a Territory government.
2 Any personal information held by Customers and the other parties mentioned above are subject to the Information Privacy Act 2009 (Qld) or the
Privacy Act 1988 (Cth).
3
Information within the system is stored in accordance with section 33 of the Information Privacy Act. This includes provisions relating to the
storage and transfer of personal information outside of Australia.
4 The Worker’s signature may be provided electronically, in accordance with the requirements stipulated in relevant legislation including the
Commonwealth (1999) and Queensland Government (2001) Electronic Transactions Acts.

Contractor Consent Form Version 4 – 30 October 2018