Attachment 7 Bereavement Leave Certification MacDill AFB HDEC0820R0024.doc
DOC document 24 KB Posted
- Solicitation number
- HDEC0820R0024
- Issued by
-
Defense Commissary Agency
About this file
This document contains a certification form for requesting payment of bereavement leave under a federal contract for shelf stocking, receiving, storage, holding area, and custodial operations at the MacDill Air Force Base Commissary in Tampa, Florida. The form requires the contractor to provide the name of the deceased and their relationship to the employee taking leave, the dates of bereavement leave taken, and certification from the contractor that the leave and payment were in accordance with the collective bargaining agreement applicable to the contract. By signing, the contractor is entitled to reimbursement from the federal government for bereavement leave payments made to employees under the terms of the contract.
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Text version
Attachment 7 Commissary: MacDill AFB
BEREAVEMENT LEAVE CERTIFICATION
REQUEST FOR PAYMENT
Contract:____________________________________
Name of Employee:____________________________
Area of Operation (circle one) Shelf Stocking, RSHA, Custodial
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 .