Attachment_7_Bereavement_Leave_Certification.docx
DOCX document 13 KB Posted
- Solicitation number
- HDEC0818R0034
- Issued by
-
Defense Commissary Agency
About this file
This document is a template for requesting reimbursement of bereavement leave under a federal contract. The template pertains to contract number HDEC08-18-R-0034 for shelf stocking, receiving, storage, holding area, and custodial operations at the Defense Commissary Agency in Kodiak, Alaska. The template requires the name of the employee, deceased individual, their relationship, dates of bereavement leave taken, and certification by a signature that the leave was in accordance with the applicable collective bargaining agreement. Upon signing, the contractor is entitled to reimbursement for bereavement leave paid to the employee.
Attachment 7 - Bereavement Leave Certification
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Text version
Attachment 7
HDEC08-18-R-0034
ATTACHMENT 7
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 .