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On the Job Tra <br />i <br />n <br />ing Pre Award Survey <br />? <br />?? <br />? <br />BUSINESS NAME: Gl l S? l?"? l?1-//G < STATE TAX I.D. # ?? ? l ?z? ? <br />ADDRESS: . <br /> )QS FEDERAL TAX LD. # 3?J --0? ?G/?/ ?? <br /> YES NO <br />1. The business does prow de worker's compensation coverage. ?'? ? <br /> Policy Number: 3 ?? ?- ? ?T ? - 1 I <br />2. The business does provide General Liability Insurance in the amount of ? ? <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 <br /> federal tax withholdings, FICA deductions. [G? ? <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. ? ? F? <br />1 O. Business license is current. (? ? <br />1 1. 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 /> The employer stipulates and agrees by signing below that the establishment in whic h on-the job <br /> training will be given: <br />(1) 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 # <br />CONTRACT RECOMMENDED YESV? NO ? <br />Comments: <br />Employer Title Date <br />Program Supervisor/Director Date