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On the Job Training Pre Award Survey <br />BUSINESS NAME: California Waters LLC STATE TAX I.D. # 3 02-1 63 29 <br />ADDRESS: <br />2909 W. Warner Ave FEDERAL TAX LD. # 27-1 1 55 1 8 <br />Santa Ana. CA 92704 <br />1. The business does provide worker's compensation coverage. x ? <br />Policy Number: CAWC240190 - 000310063 <br />2. The business does provide General Liability Insurance in the amount of x ? <br />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 x <br />federal tax withholdings, FICA deductions. ? <br />4. The business has not been cited for any health, safety, wage and hour, or child x <br />labor violations during the past 12 months. ? <br />5. The business maintains a grievance and/or complaint handling procedures for x ? <br />employees. <br />6. The prospective OJT client is not a former employee of the business. x ? <br />7. Wages for the planned OJT position are wages comparable to similar positions. x ? <br />8. A written job description for this position is on file. x ? <br />9. Union concurrence has been obtained. N/A ? <br />1 O. Business license is current. x ? <br />1 1 . The business has not had any employees laid off in the past 6 months. x ? <br />12. The business is financially stable and has the means to train and pay for the x <br />prospective OJT employee. <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 # 10 CONTRACT AWARDED YES X? NO ? <br />Comments: <br />Mark Pitman or Jeffrey Barman 03/12/2012 ? 03/12/2012 <br />Employer Title Date WIA Program Manager Date