4-CCS - SCHEDULE H1-A.pdf
PDF 122 KB Posted
- 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: |
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