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On the Job Training Pre Award Survey,,-,,,,,,_.,, <br />BUSINESS NAME: Children's Bureau STATE TAX I.D. # 26110753 <br />ADDRESS: <br />INSURANCE ON FILL to <br />4"dOR?C N1AY PROCEED 1901 W 4 St., Suite 310 FEDERAL TAX I.D. # 951690975 <br />UNTIL. INSUP,NCE EXPIRE`s <br />// _ ,2z_/p Santa Ana, CA 92705 <br />DATE: L ` he business does provide worker's compensation coverage. <br />v; C%),A Policy Number: RI00010666 <br />Koh ^a 2. The business does provide General Liability Insurance in the amount of <br />PhGm One Million Dollars ($1,000,000). Policy must identify the City of Santa Ana as <br />the certificate holder. <br />3. The system used for business accounting does document cash received, state and <br />federal tax withholdings, FICA deductions. <br />4. The business has not been cited for any health, safety, wage and hour, or child <br />labor violations during the past 12 months. <br />5. The business maintains a grievance and/or complaint handling procedures for <br />employees. <br />6. The prospective OJT client is not a former employee of the business. <br />7. Wages for the planned OJT position are wages comparable to similar positions. <br />8. A written job description for this position is on file. <br />9. Union concurrence has been obtained. <br />10. Business license is current. <br />l <br />11. The business has not had any employees laid off in the past 6 months. <br />12. The business is financially stable and has the means to train and pay for the <br />prospective OJT employee. <br />X ? <br />X ? <br />X <br />X <br />X ? <br />X ? <br />X ? <br />X ? <br />N/A ? <br />X ? <br /> <br />X <br />X <br />The employer stipulates and agrees by signing below that the establishment in which on-the-job <br />training will be given: <br />(1) Has not been moved from any previous location less than 120 days prior to the effective date of the <br />OJT contract. <br />(2) Is not a branch, affiliate or subsidiary of a business entity in another location which has, at any time <br />subsequent to the date of the OJT contract, relocated or expanded so as to cause an increase in <br />unemployment or the closing down of operations in which the entity conducts business operations. <br />TOTAL WORKFORCE # 346 <br />Employer TitlV ' Date <br />Z-t0 <br />CONTRACT AWARDED YES X NO ? <br />/%U