Attachment 4 Bereavement Leave Certificate.doc
DOC document 24 KB Posted
- Solicitation number
- HDEC08-10-R-0007
- Issued by
-
Defense Commissary Agency
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Attachment 4
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Other files
| File | Type | Posted |
|---|---|---|
| Amendment 0002 Solicitation HDEC08-10-R-0007 | — | |
| HDEC08-10-R-0007 Amendment 1.doc | DOC document | |
| Attachment 1 DD 1707.doc | DOC document | |
| HDEC08-10-R-0007.doc | DOC document | |
| Attachment 8 Vol III - Past Performance Information.rtf | RTF text file | |
| Attachment 7 TDWS DLS.xls | XLS spreadsheet | |
| Attachment 2 Performance Work Statement dated 11.30.09.pdf | ||
| Attachment 1 DD 1707.doc | DOC document | |
| Attachment 6 Vol II - Technical Capability Personnel Proposal.rtf | RTF text file | |
| Attachment 5 Vol I Cost Breakout.xls | XLS spreadsheet | |
| Attachment 3 WD Collective Bargaining Agreement.pdf |
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Text version
ATTACHMENT 4
BEREAVEMENT LEAVE CERTIFICATION
REQUEST FOR PAYMENT
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)
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