ATTACHMENT 4 - Bereavement Leave Cert 8.21.12.doc
DOC document 26 KB Posted
- Attached to
- Shelf Stocking, Receiving/Storage/Holding Area, Custodial Operations and Other Residual Grocery Tasks
- Solicitation number
- HDEC0812R0004
- Issued by
-
Defense Commissary Agency
About this file
ATTACHMENT 4 Bereavement Leave Certificate
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| Attachment_2_-_PWS_Fort_Cason_Commissary_dtd_10.03.2012.doc | DOC document | |
| HDEC08-12-R-0004_AMEND_0002.doc | DOC document | |
| Amendment_1.doc | DOC document | |
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| ATTACHMENT 1 - DD Form 1707 Info to Offerors 8.21.12.doc | DOC document | |
| HDEC08-12-R-0004.doc | DOC document | |
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| ATTACHMENT 7 - TDWS and DILS.xls | XLS spreadsheet | |
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| ATTACHMENT 3 - CBA Fort Carson 8.21.12.pdf | ||
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Text version
ATTACHMENT 4
HDEC08-12-R-0004
ATTACHMENT 4
BEREAVEMENT LEAVE CERTIFICATION
REQUEST FOR PAYMENT
FORT CARSON, COLORADO
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 .