4-CCS - SCHEDULE H1-A.pdf

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Attached to
RFP 1156 Moving Services
Solicitation number
RFP 1156 Moving Services
Issued by
Milwaukee County, Mattoon Village, Wisconsin

About this file

The document is a Schedule H1-A Student Employment Commitment form from Milwaukee Public Schools (MPS), designed to capture a contractor's commitment to providing employment opportunities for students. The form requires contractors to detail their plan for meeting student employment requirements, which can be fulfilled through various options including alternative placement sites, after-school programs, summer employment, youth apprenticeship, or other specified methods. Contractors must outline the number of required employment hours, the timeframe for employment, and provide a detailed description of their employment plan.

The form emphasizes the contractor's obligation to create an employment partnership experience for an MPS student, with potential sanctions for non-compliance. The authorized company representative must declare and affirm their commitment by signing the document, confirming they have reviewed the proposal details. An additional form (H1C) is required to be submitted alongside this document. The form includes spaces for contact information, employment plan specifics, and signatures from both the contractor and a CCS representative, with the document dated January 2017.

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Text version

SCHEDULE H1-A

Student Employment Commitment

Project/Contractor Information

CONTRACTOR COMPANY NAME MPS SITE MPS PROJECT

Name of Employment Liaison Contact

CONTACT PERSON PHONE FAX E-MAIL

Number of required hours:

Options

Place an “X” below to indicate how you plan to fulfill your student employment requirement.

ALTERNATIVE PLACEMENT SITE AFTER SCHOOL SUMMER YOUTH APPRENTICESHIP OTHER

Employment Plan – Use additional pages if necessary. Plan must meet hours required.

From to

List month

Number of employment hours

Provide a detailed description of your employment plan for this project.

I hereby declare and affirm that I, NAME TITLE am a duly authorized representative of

COMPANY NAME

located in 1

STATE COUNTY CITY

and that I have personally reviewed the material and facts describing our proposal regarding student employment. I agree to provide an employment partnership experience for the MPS student. (H1C is required to be submitted as well). If a contractor is non-compliant, MPS may impose one or more identified sanctions, and require proof of corrective action by the contractor.

SIGNATURE OF AUTHORIZED COMPANY OFFICER TITLE DATE

For Office Use Only

SIGNATURE OF CCS REPRESENTATIVE TITLE DATE

01/2017

CONTRACTOR COMPANY NAME:
MPS SITE:
MPS PROJECT:
CONTACT PERSON:
PHONE:
FAX:
EMAIL:
Number of required hours:
ALTERNATIVE PLACEMENT SITE: Off
AFTER SCHOOL: Off
SUMMER: Off
YOUTH APPRENTICESHIP: Off
OTHER: Off
From:
to:
List month:
Number of employment hours:
Provide a detailed description of your employment plan for this project 1:
Provide a detailed description of your employment plan for this project 2:
Provide a detailed description of your employment plan for this project 3:
Provide a detailed description of your employment plan for this project 4:
Provide a detailed description of your employment plan for this project 5:
NAME:
TITLE:
COMPANY NAME:
STATE:
COUNTY:
CITY:
compliant MPS may impose one or more identified sanctions and require proof of corrective action by the contractor:
undefined:
TITLE_2:
For Office Use Only 1:
undefined_2:

File details come from the government source that posted it. Updated .