Fillable Printable Sample Termination Template
Fillable Printable Sample Termination Template
Sample Termination Template
STRICTLY CONFIDENTIAL
WITHOUT PREJUDICE
DATE
NAME
ADDRESS
Dear NAME:
This is to advise you that your employment with CLINIC NAME will terminate effective
DATE, due to (reasons discussed in our meeting held DATE; or, you may opt not to
provide a reason). This termination is without cause.
We will provide you with termination pay and a severance package (remove severance
package if not applicable), the details of which are outlined in the attached Termination
Agreement, (Appendix A). This amount is inclusive of any payments, statutory or
otherwise, which may be owed to you under the Ontario Employment Standards Act.
[Note: you also have the option of providing employees with working notice]
This termination agreement is open for your review and acceptance until DATE.
We would also like to take this opportunity to remind you that, notwithstanding the
termination of your employment with the CLINIC NAME, certain of your obligations
under your employment contract and other agreements that you may have signed during
your employment with the Company continue. These obligations include, but may not
be limited to, obligations of confidentiality and obligations relating to any intellectual
property to which you may have contributed while employed by CLINIC NAME.
If you have any questions concerning the information contained in this letter, please
contact me directly.
Sincerely,
NAME
TITLE
I, NAME, hereby accept the terms set out in Appendix A, in full and final satisfaction of
any claims that I may have.
_______________________________________ _______________
Signature Date
Note: A signature is not required if entitlements are the minimum set forth by the
Employment Standards Act. In this case, remove the signature field from the letter.
APPENDIX A
Termination Agreement Between
CLINIC NAME and NAME
This Agreement confirms the circumstances surrounding the termination of your
employment with COMPANY, known as CLINIC NAME.
1. Termination Date
Your employment with CLINIC NAME will terminate effective DATE.
2. Notice
CLINIC NAME will provide you with a lump sum payment equal to NUMBER (X)
week’s base salary, representing your notice and entitlement as prescribed under
the Employment Standards Act, 2000. Payment will be made through the usual
means as part of the DATE pay cycle.
OR
The period between TODAY’S DATE and TERMINATION DATE is referred to in
this agreement as the “notice period”. During the notice period your employment
status will remain unchanged.
3. Severance [NOTE: Depending on the length of service this clause may not be
necessary]
COMPANY will provide you with a lump sum payment equal to NUMBER (X)
base salary, representing your severance and entitlement as prescribed under
the Employment Standards Act, 2000.
4. Vacation
Any outstanding vacation owing will be paid to you as a lump sum, less applicable
statutory deductions. Payment will be paid through the usual means as part of the DATE
pay cycle.
5. Group Benefits [Note: Remove this section if you do not offer group benefits]
Your group benefits coverage will continue for NUMBER (X) of weeks. (should be same
as the number in 2) You have the option of converting your life insurance to an
individual policy, as long as it is done within NUMBER (X) (depends on your life
insurance plan) days after TERMINATION DATE. [NOTE: this is a legal requirement
if you offer life insurance under your group plan]
6. Additional Payment [NOTE: Depending on the terms of the applicable
employment contract, an additional amount may not be necessary or desired.
Legal advice should be sought on this point]
In addition to the above items and conditional upon the signing and returning of the
attached Full and Final Release, the Company is pleased to provide you with the
following additional assistance:
a) An additional payment equal to an additional NUMBER (X) (number of
additional weeks) weeks of base salary paid through the usual means on
“DATE” OR “THE COMPANY’S REGULARLY SCHEDULED PAYROLL
CYCLE OVER THE NEXT NUMBER (X) WEEKS”
b) Your current benefits, with the exception of (name any excluded benefits),
will continue for an additional NUMBER (X) (should be the same as 6(a)) of
weeks or until you obtain alternate employment or commence participation in
a business interest, whichever occurs first.
The offer contained in Section 6 is conditional upon your agreement to keep the terms
hereof strictly confidential. You may only disclose the terms of this offer to your
immediate family members and your legal and financial advisors. Any unauthorized
disclosure of the terms of this offer shall immediately terminate the offer.
7. Expenses [Note: Remove this section if it is not applicable]
CLINIC NAME will reimburse you for all reasonable business expenses incurred, up to
and including (TERMINATION DATE), provided you submit appropriate forms and
supporting original receipts no later than XX days from this date.
8. Record of Employment
Your Record of Employment will be provided to you no later than 5 days after the last
payment made to you by the Company under the terms hereof. You will need to present
this form to your local Human Resources and Skills Development Canada (HRSDC) in
the event that you qualify for employment insurance benefits.
9. Change of Address
In the event that you change your address, please notify NAME at PHONE# or via email
at [email protected] so that we can arrange to forward your 20XX T4 to the correct address.
10. References
At your request, we will provide you with a letter confirming your employment with
CLINIC NAME, according to our usual practices.
11. Return of Company Property
Upon termination of your employment, you are required to return all COMPANY property
and material in your possession and are not to retain copies of such materials.
12. Release
Any additional payments (above the minimum statutory legislation) is conditional upon
your having signed, witnessed dated and returned the attached copy of this letter and
the Release form (Appendix B) to NAME by DATE.
RELEASE
WHEREAS the undersigned (the “Releasor”) was an employee of [CLINIC NAME] (the
“Company”);
AND WHEREAS the Releasor’s employment with the Company has been terminated,
NOW THEREFORE THIS AGREEMENT WITNESSETH that in consideration of the
Company’s offer to provide payments to the Releasor over and above the Releasor’s
statutory entitlement, and for other valuable consideration, the receipt and sufficiency of
which is hereby acknowledged, the Releasor covenants and agrees as follows:
1. FULL AND FINAL RELEASE
The Releasor does hereby release and forever discharge the Company, its successors,
administrators, assigns, affiliates and related companies, and their directors, officers and
employees (the “Released Parties”) of and from all actions, causes of action, damages,
claims, cross claims and demands whatsoever, (including all damage, loss and injury not
now known or anticipated but which may arise in the future and all effects and
consequences thereof), however and wherever arising, which the Releasor had, now
has, or which the Releasor, its heirs, administrators and assigns or any of them hereafter
can, shall or may have in respect of the Releasor’s employment by the Company or the
termination thereof.
The Releasor further agrees not to make or continue any claim or take or continue any
proceeding against the Released Parties in Canada or elsewhere in the world, with
respect to the employment of the Releasor by the Company or with respect to the
termination of the Releasor’s employment.
The Releasor warrants that the Releasor has disclosed to the Company any and all
human rights complaints, concerns or issues arising out of or in respect of the
Releasor’s employment at the Company. The Releasor confirms that the Releasor is
aware of the Releaser’s rights under the Human Rights Code (Ontario) and warrants that
the Releasor knows of no violation of the Releasor’s rights under the Human Rights
Code (Ontario) during the term of the Releasor’s employment with the Company and is
not asserting any rights or advancing any human rights claim or complaint pursuant to
the Human Rights Code (Ontario).
It is understood and agreed that both this release and any consideration transferred
hereunder are deemed to be no admission whatsoever of liability on the part of the
Released Parties.
2. CONFIDENTIALITY UNDERTAKING
The Releasor, intending to be legally bound, hereby further agrees and undertakes to
protect in strict confidence, and not to use or disclose, any and all information relating to
the terms and the fact of this Release.
It is further understood that the Releasor will continue to be bound by any and all
confidentiality agreements signed by the Releasor while in the employ of the Company,
and the Releasor recognizes that the full force of penalties and consequences pertaining
to the breach of said agreements remain in full force.
3. BENEFIT OF RELEASE, AGREEMENT AND UNDERTAKING
It is understood and agreed that this Release shall enure to the benefit of the Released
Parties and shall be binding on the Releasor, the Releasor’s successors, administrators,
assigns, affiliates and related companies.
The Releasor’s acknowledges that the signing of this Release is not a condition for the
Releasor to receive any money to which the Releasor would otherwise be entitled to by
operation of statute.
The Releasor hereby declares that it fully understands the terms of this settlement, has
had the opportunity to obtain independent legal representation in connection with this
Release and that it voluntarily accepts same for the purpose of making full and final
compromise, adjustment and settlement of all claims as aforesaid, whether arising by
force of contract, at common law, or under applicable statutes.
IN WITNESS WHEREOF this agreement has been executed before the undersigned
witness by the Releasor on the ____ day of ______________, 20XX.
SIGNED, SEALED AND DELIVERED
)
SIGNED in the presence of )
)
)
)
__________________________ ) _____________________________
WITNESS ) RELEASOR
Name: ) Name:
)
