Temporary_Employee_Retiriee_Disclosure_Form.pdf

This is a Temporary Employee Retiree Disclosure Form required by the City of Tucson for temporary staffing placements under the Temporary Employment and Staffing Services solicitation, which is being conducted in conjunction with Pima County and the Axia Cooperative purchasing program. The form must be completed by all temporary employees prior to beginning assignment with the City, and the staffing contractor is responsible for collecting and submitting the form to the City before the employee's first day. The form requests employee information including full name, last four digits of Social Security Number, contractor agency, and position/department of assignment. A non-mandatory pre-submittal meeting is scheduled for February 4, 2026, at 10:00 a.m. via Microsoft Teams, with questions due by February 19, 2026, at 8:00 a.m., and proposals due by February 27, 2026, at 2:00 p.m. through the City's online bidding system. The resulting contract will have a one-year initial term with City options to extend for up to four additional one-year periods.

The form requires temporary employees to disclose their retirement status, specifically whether they are retirees of the Tucson Supplemental Retirement System (TSRS) or the Public Safety Personnel Retirement System (PSPRS). Employees who are TSRS or PSPRS retirees cannot be placed without prior written approval from the City of Tucson Human Resources Department. The form must be signed by the employee, contractor representative, and City Human Resources Department, with failure to disclose accurate information resulting in immediate removal from assignment. Vendors participating through the Axia Cooperative must commit to a 2 percent administrative fee of total net sales and maintain comprehensive insurance coverage including $2,000,000 commercial general liability per occurrence. All temporary employees must also comply with the City's Living Wage Ordinance, Affordable Care Act requirements, Section 3 prevailing wage and labor hour requirements, Davis-Bacon Act prevailing wage determinations, and E-Verify employment verification for contracts exceeding $50,000.