Attachment 7 - Bereavement Leave Certification Form.doc
DOC document 28 KB Posted
- Solicitation number
- HDEC08-21-R-0007
- Issued by
-
Defense Commissary Agency
About this file
This document contains an attachment for a bereavement leave certification form and information on a federal contract opportunity for shelf stocking, receiving, storage and handling (RSHA), and custodial services at the Fort Bragg South Commissary.
The attachment is a bereavement leave certification request for payment form to be used under the applicable collective bargaining agreement. It requires information on the employee, deceased individual, their relationship, dates of bereavement leave taken, and certification by a representative that leave was taken and paid in accordance with the agreement terms, entitling the contractor to reimbursement.
The federal contract opportunity is solicitation number HDEC08-21-R-0007 to provide shelf stocking, RSHA, and custodial operations at the Fort Bragg South Commissary for the Defense Commissary Agency. No further details are provided on the required products or services, response date, or other terms.
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Other files
| File | Type | Posted |
|---|---|---|
| PIEE_Solicitation_Module_Vendor_Access_Instructions.pdf | ||
| Posting_Offer.pdf | ||
| Attachment 5 - Typical Daily Work Schedule and Direct Labor Summary.xlsx | XLSX spreadsheet | |
| Attachment 2 WD.pdf | ||
| Attachment 3 - Volume I - Cost Breakout.xls | XLS spreadsheet | |
| Attachment 6 - Past Performance Information.doc | DOC document | |
| HDEC08-21-R-0007.pdf | ||
| Attachment 1 - Fort Bragg South Commissary PWS 5.18.21.docx | DOCX document | |
| Attachment 4 - Volume II - Technical Capability and Personnel.doc | DOC document |
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Text version
ATTACHMENT 7
BEREAVEMENT LEAVE CERTIFICATION
REQUEST FOR PAYMENT
FORT BRAGG SOUTH COMMISSARY
Contract Number:________________________________________________________
Store Locations: _________________________________________________________
Name of Employee:_______________________________________________________
Area of Operation (circle one): Shelf Stocking / Custodial / RSHA Name of Deceased:_______________________________________________________
Relationship to Employee:_________________________________________________
Dates of Bereavement Leave:_______________________________________________
I certify that the above named individual took Bereavement Leave in accordance with the provision of the Collective Bargaining Agreement (CBA) applicable to abovementioned contract and that the individual was paid according to its provisions. Pursuant to said agreement, the contractor is entitled to reimbursement.
(Signature)
(Name, Position, and Date)
File details come from the government source that posted it. Updated .