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I further certify that, to the best of my knowledge, this individual is not a current employee of Northern Illinois University and is otherwise eligible to be considered an independent contractor, based on a thorough assessment of the employment conditions. This statement is therefore approved for payment."Printed Name of Authorizing Person Budget Acct..Independent Contractor Certification StatementI certify that I have been engaged as an independent contractor and performed the service(s) identified above for Northern Illinois University. I further certify that I am not currently employed by Northern Illinois University and that, to the best of my knowledge, this independent contractor designation is in accordance with applicable policies and guidelines. I also understand that the University will report to the Internal Revenue Service on Form 1099 all payments made to me during this calendar year.Printed Name of ContractorAuthorizing Signature Independent Contractor SignatureName of Service Provider:Address of Service Provider:Date Service to Begin:#Hourly/Salary Rate (if applicable):Total Amount to be Paid:=Independent contractor status must be determined before any work is performed. Please use the Independent Contractor Questionnaire to assist in making this determination. 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