EXHIBIT_5_Record_of_Training_Completion_FO.pdf

EXHIBIT 5

RECORD OF TRAINING COMPLETION

Vendor Name: Contract Number:

NAME OF EMPLOYEE:

DATE: Contract Year:

I hereby certify that the above-named employee has completed basic training as listed below:

SUBJECT COMPLETION DATE COURSE HOURS

I CERTIFY THAT ALL OF THE STATEMENTS MADE BY ME ARE TRUE, COMPLETE, AND CORRECT TO THE BEST OF MY KNOWLEDGE AND

BELIEF, AND ARE MADE IN GOOD FAITH.

CONTRACTOR'S PRINTED NAME:

CONTRACTOR'S SIGNATURE: DATE:

EXHIBIT 5 cont.

CONTRACTOR’S CERTIFICATION OF TRAINING

Employee’s Name: ____________________________________________

Last 4 SSN: _____________________________

I hereby certify that the above named employee has successfully completed

_______hours of required _______________________ Training subjects including practical exercises and examinations as required by Contract number ___

Training was provided from ______________ to _______________

(DATE) (DATE)

The ________________________________as identified in the contract was presented by: ______________________ of ______________________________ (Name of Instructor) (Name of Company)

Comments:_________________________________________________________________

Contact Employee’s Score: ________

Contract Employee’s Signature: _____________________________