Attachment 7, Bereavement Leave Certification.doc

DOC document 23 KB Posted

Attached to
Shelf Stocking, Receiving/Storage/Holding Area (RSHA), Custodial, and Residual Grocery
Solicitation number
HDEC0819R0014
Issued by

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This document contains an attachment for a federal contract opportunity and the related solicitation. The attachment is a bereavement leave certification request form to be used under the Collective Bargaining Agreement for the Fort Leonard Wood Commissary contract.

The solicitation is seeking proposals to furnish all necessary supervision, personnel, equipment, and supplies to perform shelf stocking, receiving, storage, holding area operations, custodial services, and residual grocery operations for the Defense Commissary Agency Fort Leonard Wood Commissary. The base period of performance is from July 1, 2020 through June 30, 2021 with four one-year option periods. This is a 100% set-aside for woman-owned small businesses with a NAICS code of 561990 and size standard of $12 million. The solicitation and attachments will be available on FedBizOpps on or about November 8, 2019 with a closing date of on or about December 27, 2019. A site visit is scheduled for November 29, 2019.

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Other files

File Type Posted
Attachment 4_Volume II Technical Capability & Personnel proposal Amd 0005.doc DOC document
Attachment 3, Amd 0005 - Volume I Cost Breakout.xls XLS spreadsheet
Amendment 0005 - HDEC08-19-R-0014.pdf PDF
Attachment 3, Volume I Cost Breakout Amendment 0004.xls XLS spreadsheet
Attachment 5, Typical Daily Work Schedule & Direct Labor Summary Amendment 0004.xls XLS spreadsheet
Attachment 1, PWS Fort Leonard Wood Amendment 0004.docx DOCX document
Amendment 0004 - HDEC08-19-R-0014.pdf PDF
Amendment-0002-HDEC08-19-R-0014.pdf PDF
Amendment HDEC08-19-R-0014-0001.pdf PDF
Attachment 3, Volume I Cost Breakout.xls XLS spreadsheet
Solicitation HDEC0819R0014.pdf PDF
Attachment 6, Past Performance Information.doc DOC document
Attachment 1, PWS Fort Leonard Wood.docx DOCX document
Attachment 2, WD 2012-0098 Rev 7 dated 26 December 2018 & CBA dated 1 July 2015.pdf PDF
Attachment 5, Typical Daily Work Schedule & Direct Labor Summary.xls XLS spreadsheet
Attachment 4, Volume II Technical Capability & Personnel proposal.doc DOC document
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ATTACHMENT 7

BEREAVEMENT LEAVE CERTIFICATION

REQUEST FOR PAYMENT

FORT LEONARD WOOD COMMISSARY

Contract Number: ________________________________________________________

Store Locations: _________________________________________________________

Name of Employee: _______________________________________________________

Area of Operation (circle one): Store Worker I / Janitor / Material Handling Laborer / Warehouse Specialist / Forklift Operator 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 .