3-Attachment F - URS Post-Retired Verification Form.pdf

This is a URS Post-Retired Verification Form for Independent Contractors used by Jordan School District in Utah to verify retirement status for individuals seeking to work as contractors or 1099 employees. The form requires contractors to disclose whether they have retired from the Utah Retirement Systems (URS) and, if applicable, provide their signature and date. Contractors identified as retirees must complete the form alongside a W-9 and submit both documents to the Accounting Department prior to commencing work with Jordan School District.

The form establishes critical compliance requirements for URS retirees engaging in re-employment with Jordan School District. Retirees receiving monthly URS benefits face restrictions on returning to work, whether as paid employees through payroll or as independent contractors paid through accounting. Contractors must notify URS's Retirement Benefits Department at 801-366-7770 before beginning work and complete Form RTRT-27A (Post-Retirement Employment form) as required by Utah Code Section 49-11-1207(2). Failure to report re-employment status results in personal liability for repayment of any URS benefit overpayments resulting from non-disclosure. This verification process applies specifically to the Greenhouse Upgrade project at JATC South, which is being procured through an Invitation for Bid in accordance with the State of Utah Procurement Code and applicable administrative rules.