Laserfiche WebLink
<br />Exhibit C <br />COUNTY OF SAN MATEO <br />Equal Benefits Compliance Declaration Form <br /> <br />I Vendor Identification <br />Name of Contractor <br />Contact Person <br />Address: <br /> <br />Phone Number <br />Fax Number <br /> <br />City of Redwood City - Fair Oaks Community Center <br />Teri Chin, ExQQl:-Jtive DirÐGter \tuxnll'Y' "Se-v v' ce<; Kcu'\~^" <br />2600 Middlefield Road <br />Redwood City, CA 94063 <br />(650)780-7500 <br />(650) 298-8184 <br /> <br />" Employees <br /> <br />Does the Contractor have any employees? ~"Yes D No <br /> <br />Does the Contractor provide benefits to spouses of employees? l~Yes D 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 />~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 />D Yes, the Contractor complies by offering a cash equivalent payment to eligible employees <br />in lieu of equal benefits. <br />D No, the Contractor does not comply. <br />D The Contractor is under a collective bargaining agreement which began on <br />and expires on (date). <br /> <br />(date), <br /> <br />IV Declaration <br /> <br />I declare under penalty of perjury under the laws of the State of California that the foregoing is true and <br />correct, and hat I am au orized to bind this entity contractually. <br /> <br /> <br />"Tex-¡ (P'Ý\ <br />Name (Please Print) <br /> <br />\-\uJ1'\(.Ly) S' en) ¡ c t"" S. KCLt" Ct 3 e.r <br />Title <br /> <br />q /~CIDS <br /> <br />Date <br />