FIRST_SOURCE_JOBS_ORDINANCE_May_2025 (3).pdf

WorkSource DeKalb – Standard Operating Procedures – Business Solutions Unit

Revised September 2020 Page 10 WorkSource DeKalb (WSD) is an EEO/M/F/D/V employer/program. Auxiliary aids/services are available upon request to individuals with disabilities. Persons with hearing impairments may call 1‐800‐255‐0135 or 711 TTY for assistance. WSD is 100% funded by the U. S. Department of Labor and is a proud partner of the American Job

Center Network.

D. FIRST SOURCE ACKNOWLEDGEMENT FORM

First Source Jobs Ordinance Acknowledgement

The DeKalb County First Source Ordinance requires contractors or beneficiaries of eligible projects entering into any type of agreement with the County, including purchase orders, regardless of what they may be called, for the procurement or disposal of supplies, services, construction projects, professional or consultant services, which is funded in whole or part with County funds or County administered funds in which the contractor is to receive $50,000 or more in County expenditures or committed expenditures and recipient of urban redevelopment action grants or community development block funds administered in the amount of $50,000 or more to make a good faith effort to hire DeKalb County residents for at least 50% of jobs created using the First Source Registry (candidate database) within one hundred twenty (120) days of contract execution. The work to be performed under this contract is subject to the provisions of the DeKalb County First Source Jobs Ordinance. All contractors will be asked to submit an Employment Roster and/or copies of active payroll registers on a monthly basis to verify compliance. The undersigned acknowledges and agrees to comply with the provisions of the DeKalb County First Source Jobs Ordinance.

CONTRACTOR OR BENEFICIARY INFORMATION:

Contractor or Beneficiary Name (Signature)

Contractor or Beneficiary Name (Printed)

Title

Telephone

Email

Name of Business

Please answer the following questions:

1. How many job openings do you anticipate filling related to this contract? _____

2. How many incumbents/existing employees will retain jobs due to this contract?

DeKalb Residents: _____ Non-DeKalb Residents: _____

3. How many work hours per week constitutes Full Time employment? ______ Please return this form to WorkSource DeKalb, (404)687-3900 or email to WSDBusiness@dekalbcountyga.gov

Revised September 2020 Page 11 WorkSource DeKalb (WSD) is an EEO/M/F/D/V employer/program. Auxiliary aids/services are available upon request to individuals with disabilities. Persons with hearing impairments may call 1‐800‐255‐0135 or 711 TTY for assistance. WSD is 100% funded by the U. S. Department of Labor and is a proud partner of the American Job

Center Network.

E. NEW EMPLOYEE TRACKING FORM

Name of Bidder__________________________________________________________________

Address_________________________________________________________________

E- Mail____________________________________________________________________

Phone Number_________________________________________________________________

Fax Number_________________________________________________________________

Do you anticipate hiring from the First Source Candidate Registry? Y or N (Circle one)

If so, the approximate number of employees you anticipate hiring:

Type of Position(s) you anticipate hiring:

(List position title, one position per line)

Attach job description per job title:

The number you anticipate hiring:

Timeline

Revised September 2020 Page 12 WorkSource DeKalb (WSD) is an EEO/M/F/D/V employer/program. Auxiliary aids/services are available upon request to individuals with disabilities. Persons with hearing impairments may call 1‐800‐255‐0135 or 711 TTY for assistance. WSD is 100% funded by the U. S. Department of Labor and is a proud partner of the American Job

Center Network.

F. BUSINESS SERVICE REQUEST FORM

Please complete this form for each position that you have available.

DATE: FEDERAL TAX ID:

COMPANY NAME: WEBSITE:

ADDRESS:

(WORKSITE ADDRESS IF DIFFERENT):

CONTACT NAME: TITLE:

CONTACT E-MAIL ADDRESS: CONTACT PHONE:

Are you a private employment agency or staffing agency? YES NO

JOB DESCRIPTION: (Please include a copy of the Job Description)

POSITION TITLE: ____________________________________________________________

NUMBER OF POSITIONS AVAILABLE: _________ TARGET START DATE: _________________

WEEKLY WORK HOURS: 20-30 hours 30-40 hours Other ________________

SALARY RATE (OR RANGE): ________________ SPECIFIC WORK SCHEDULE: ___________

PERM TEMP TEMP-TO-PERM SEASONAL

PUBLIC TRANSPORTATION ACCESSIBILITY: YES NO

SCREENINGS ARE REQUIRED: YES NO SELECT ALL THAT APPLY:

BACKGROUND CREDIT CHECK DRUG MVR OTHER __________________

HOW TO APPLY:

Please return form to: WSDBusiness@dekalbcountyga.gov

DO NOT WRITE BELOW THIS LINE - TO BE COMPLETED BY WORKSOURCE DEKALB ONLY

SYSTEM

TYPE: First Source Direct Hire Work Experience (WEX) ENTRY DATE:

ASSIGNED TO: _______________________________________ DATE: _____________

Revised September 2020 Page 13 WorkSource DeKalb (WSD) is an EEO/M/F/D/V employer/program. Auxiliary aids/services are available upon request to individuals with disabilities. Persons with hearing impairments may call 1‐800‐255‐0135 or 711 TTY for assistance. WSD is 100% funded by the U. S. Department of Labor and is a proud partner of the American Job

Center Network.

G. EMPLOYMENT ROSTER

DeKalb County

Contract Number: _________________________

Project Name: ____________________________

Contractor: ______________________________ Date: ___________

Name Position: Start Date

Hourly Rate of

Pay

Hired for this Project?

(yes/no)

Anticipated Length of

Employment (Months)

% of Time Dedicated to the Project

Full or Part

Time?

(No. of Hours)

Georgia County of Residency