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<br />Exhibit C <br />COUNTY OF SAN MATEO <br />Equal Benefits Compliance Declaration Form <br /> <br />I Vendor Identification <br /> <br />Name of Contractor: <br />Contact Person: <br />Address: <br /> <br />City of Redwood City <br />Teri Chin <br />2600 Middlefield Road <br />Redwood City,CA 94063 <br />ñ~O- 7RO- 7393 <br /> <br />Phone Number: <br />Fax Number: <br /> <br />II Emplovees <br /> <br />Does the Contractor have any employees? 0 Yes 0 No <br />Does the Contractor provide benefits to spouses of employees? 0 Yes 0 No <br /> <br />*If the answer to one or both of the above is no, please skip to Section IV: <br /> <br />III EQual Benefits Compliance (Check one) <br /> <br />0 Yes, the Contractor complies by offering equal benefits, as defined by Chapter 2.93, to its <br />employees with spouses and its employees with domestic partners. <br />0 Yes, the Contractor complies by offering a cash equivalent payment to eligible employees <br />in lieu of equal benefits. <br />0 No, the Contractor does not comply. Q nM'\extrs <br />I2ลก The Contractor is under a collective bargaining ~gr:g9meflt which began on OCt"ob~ I » ~CO I <br /> <br />(date) , and expires on Se.pi"ember 30 J 'd.OO5" (date).) <br /> <br />(U"lcÅ oe9LL\'\ on Fe.bl'"uC-r,y \) ~OO'1 (U')d ex \YI'('e~ oV) ~cu,,)úð..;-~ 31 ) ~OO8 <br /> <br />IV Declaration <br /> <br />I declare under penalty of perjury under the laws of the State of California that the foregoing is <br />true and,C<)rrect. ~. at. I am ~uthorized to bind this entity contractually. , <br /> <br />Cfß~ ~ (V\6-C cl c.. GóY\ 'ì:c.lQ ~ <br />ignature -/ N~e (Please Print) <br /> <br />(k ~. Cd; IY 1tvt or <br />Itle <br /> <br />B 'l L~Gl.l <br />Date <br /> <br />13 <br />