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County of San Mateo <br /> Contractor's Declaratfon Form <br /> L CONTRACTORINPORMATION <br /> ContractorName: C' ofRedwood C' Phone: 650-780-7301 <br /> Contact Person: RobeR B. Bell Fax: 650-298�184 <br /> Address: City Hall 7017 Middlefield Rd <br /> Redwood C' , CA 94063 <br /> II. EQUAL BENEFITS (check one or more boxes) <br /> Corrtrado w'dh confracts in excess o($5,000 must beat spouses and domesfic parfners equally as to employee benefits. <br /> �..Contractor complies with ihe County's Equal Beneflfs Ordinance by: <br /> � offering equal benefits to empioyees with spouses and employees with domestic paMers. <br /> %ffering a cash equivaleM payment to eligibie employees in lieu of equal benefits. <br /> Contradnr does not comply with ihe County's Equsl Benefits Ordinance. <br /> Contractor is exempt from this requireme� because: <br /> Co�tractor has no empbyees, does not provide benefits to empbyees' spouses, or the contract is for $5,000 <br /> or less. <br /> Contractor is a party to a collective bargaining agreement that began on _(date) and expires on _(date),. <br /> and imends to offer equal benefils when said agreemeM expires. <br /> III. NON•DISCRIMINATION (check appropriate box) <br /> Finding(s) of dfurimination have been issued against ConUactor wiCiin the past year by fhe Equal Empbyment <br /> Opporlunity Commissan, Fair Employment and Housing Commission, or other investigative entity. Please see <br /> ed sheet of paper explaining the outcome(s) or remedy for the discrimination. <br /> o find'mg of discrimination has been issued in ihe past year against the Contractor by ihe Equal Employment <br /> Opportunity Commission, Fair Employmem and Housing Commission, ar any other entity. <br /> N. EMPLOYEE JURY SERVICE (check one or more boxes) <br /> Contractors wifh original or amended contracts in excess of $100,400 must have and adhere to a written policy that <br /> provldes !fs employees living in San Mateo Courrty up to B�re days iegular pay for actual jury service in the County. <br /> �Contractor complies with the County's Empbyee Jury Service Ordinance. <br /> Contractor does not comply with the County's Empinyee Jury Service Ordinance. <br /> Contractor is exempt from this requirement because: <br /> tt�e conVact is for $100,000 or less. <br /> Contractar is a party to a collective bargafning eg�eement ihat began on _(date) and expires on _(date), <br /> and intends to comply when !he coilective bargaining agreement expires. <br /> I declare under penalty of perjury under the laws of the State of Califomia that the foregofng is true and correct, <br /> and that I am authar¢ed to bind this entity eontractually. <br /> c�'S� ��.� p �J • �j ( � <br /> Signature Name <br /> f�C�i;��� v ll �� � 1 Ci .--�������u e r � <br /> Date Ti�e � <br /> 1 �/ <br /> Attest: <br /> Silvia Von erlin en, City Clerk <br />