Attachment 7 - Bereavement Leave Certification Form.doc
DOC document 28 KB Posted
- Solicitation number
- HDEC08-21-R-0010
- Issued by
-
Defense Commissary Agency
About this file
This document contains a bereavement leave certification form and information about a federal contract opportunity for shelf stocking, receiving/storage/holding area, and custodial operations at the Fort Bragg North Commissary. The bereavement leave certification form is to be used by an employee or contractor to request reimbursement for bereavement leave taken in accordance with a collective bargaining agreement. It requires the employee's name, relationship to the deceased, dates of bereavement leave taken, and certification by a manager.
The related federal contract opportunity is solicitation number HDEC08-21-R-0010 for shelf stocking, RSHA, and custodial services at the Fort Bragg North Commissary. The opportunity is issued by the Defense Commissary Agency for shelf stocking, receiving, storage, holding area operations, and custodial services. No further details are provided on response dates, award dates, pricing terms, set asides, or incumbent.
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Other files
| File | Type | Posted |
|---|---|---|
| HDEC08-21-R-0010.pdf | ||
| Amendment 0005.pdf | ||
| Amendment 0004.pdf | ||
| Amendment 0001.pdf | ||
| Amendment 0003.pdf | ||
| Attachment 3 - Volume I - Cost Breakout.xls | XLS spreadsheet | |
| Attachment 4 - Volume II - Technical Capability and Personnel.doc | DOC document | |
| Attachment 2 - Collective Bargaining Agreement (CBA).pdf | ||
| solicitation.pdf | ||
| Attachment 6 - Past Performance Information.doc | DOC document | |
| Attachment 5 - Typical Daily Work Schedule and Direct Labor Summary.xlsx | XLSX spreadsheet | |
| Attachment 1 - Fort Bragg North Commissary PWS dtd 06..8.2021.docx | DOCX document |
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Text version
ATTACHMENT 7
BEREAVEMENT LEAVE CERTIFICATION
REQUEST FOR PAYMENT
FORT BRAGG NORTH COMMISSARY
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 .