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_.OUNTY OF ,SAN MATEO _ <br /> <br /> Equal Benefits Compliance Declaration Form <br /> <br />I Vendor Identiltcafion <br />Name of Conka~or: Re~wood City. Jchool District <br />Contact Person: "" ~dna±d f; ura~s ..... <br />Add~$~: _ 750 B~ad~Ord St. - <br />Phone Ntlmber: ~ -z+2'~'z2J0 <br />Fax Number; <br /> <br />!1 Employees' <br /> <br /> Doe~ the Con~or hav~ any employees?. ~ Yes ~ No ' <br /> Doe~ ~e Contractor pm~de' benefl~ to ~pouse~ of employee~? ~ Yes <br /> 'If th~'~n~ur ~ ~ne ~t both of ~e abo~ is n~, ple~ ~ ~ Semen IV.' <br /> <br /> III Equil ~J~b Complianc~ {Check one) <br /> <br /> ~ Ye~, the Contra~or compllee by u~e~g equal benefit, as defined by ChaPter 2.9~, to <br /> employees with sp~use~ and its employes ~th demotic pa~nem. " -' <br /> ~ Ye~, ~e'Con~or ~mpli~ by ~redng a ~sh cquivalent payment to ~lJg~le <br /> in lieu of equal benefita. <br /> ~'No, ~e Con~a~r doe'., not ~mply. <br /> ~ ~e Con~r is under a ~lle~ive b~rgaining agr~ma~ which ~gan <br /> (da~) and expir~ on .(date). " <br /> <br /> I deolar~ under penal~ of p~u~ under ~e laws ~ t~ ~te of ~l~&mia ~at <br /> ~ and corr~ ~n4 th~ I am aumo~z~ to. bindffii~W co,tmctual¥... " <br /> <br /> ~ec~dths' [7~yof'~eb. 2001 ~ [ed~oo~ C~7, CA' 9b063 <br /> CaZ~o~[a ...... ~ '-- ' .'(C~}' .. ' ' " <br /> .~ "" '" ao~ald-.F. Crates, Ed.D. <br /> Signature Name (please Print) <br /> <br /> r "~ " ~.l~orT~ 18enflfi~flon Number <br /> <br /> TOTAL P.O1 <br /> <br /> <br />