Temporary_Employee_Retiriee_Disclosure_Form.pdf

This is a Temporary Employee Retiree Disclosure Form developed by the City of Tucson, Arizona, required for all temporary employees placed through the City's Temporary Employment and Staffing Services contracts, which are administered through the Axia Cooperative purchasing program in conjunction with Pima County. The form must be completed by temporary employees prior to beginning any assignment and submitted by the contractor agency to the City before the employee's first day of work. The form captures basic employee information, including name and last four digits of Social Security Number, contractor agency details, and position/department of assignment. A critical component of the form addresses retirement status disclosure, requiring employees to indicate whether they are retirees of the Tucson Supplemental Retirement System (TSRS) or the Public Safety Personnel Retirement System (PSPRS), as employees with retiree status from either system cannot be placed without prior written approval from the City of Tucson Human Resources Department. The form requires signatures from both the employee and the contractor representative, followed by approval authorization from the City's Human Resources Department, with failure to disclose accurate information resulting in immediate removal from assignment.

The disclosure form serves as a compliance and vetting mechanism for the City's temporary staffing arrangements and does not establish pricing, set-asides, or funding terms. Rather, it functions as a prerequisite administrative document within the broader temporary employment and staffing services solicitation framework, which encompasses General Clerical and Administrative Staffing, Information Technology Staffing, and Finance and Business Services Staffing categories. The form reinforces the City's regulatory requirements regarding retirement system restrictions and ensures that contractors maintain accurate employee records and comply with all disclosure obligations prior to worker deployment.