[Date]
September 28, 2010
David Marx
dmarx@outcome-
RE: Letter Agreement for Continuing Medical Education Speaking Engagement
Thank you for accepting our invitation to speak to our Medical Staff and provide Continuing Medical Education on “Physicians Behaving Badly or Human Error? Creating a Fair and Just Culture at Sutter,” which you will be giving on October 5, 2010. We have agreed that Sutter Health Sacramento Sierra Region, on behalf of Sutter Medical Center, Sacramento, will pay the usual and customary expert speaking engagement fee of $2,500.00 plus reasonable travel expenses for your services.
You will be serving as an independent contractor and not an employee of the Hospital. We have agreed that Sutter Health Sacramento Sierra Region will not deduct any amount from your compensation for any taxes, payment of which will be your sole responsibility. We also have agreed that this engagement will last only for the CME speaking engagement.
This payment is consistent with the personal services arrangement exception under the Stark anti-referral laws and any nominal meals or beverages provided at the event are included as an incidental benefit to this services arrangement.
Please sign below indicating your agreement to these terms. Please also provide your company’s tax identification number or your individual social security number so that payment and issuance of IRS Form 1099 will be appropriately made.
Sincerely,
Kristine Wakefield, CMSC, CPCS
Manager, Medical Staff/CME/Credentialing Services
Sutter Medical Center, Sacramento
AGREED AND ACKNOWLEDGED:
_______________________________________________ ___________________
David Marx, Outcome Engineering Date
CEO and President
Corporate Tax ID or Social Security Number: ___________________________________
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