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On the Job Training Agreement Checklist <br />BUSINESS NAME: Pig's Tail USA. LLC <br />YES NO <br />1. Pre Award Survey .? ? <br />2. OJT Agreement Template: Training dates (pg 1), reimbursement rate (pg 1), and .?? ? <br /> maximum reimbursement amount (pg 4), and Employer Info (pg 5) match Exhibit <br /> A-Training Plan. <br />3. Exhibit A: Training Plan <br />a ? _..,. e eva , ? <br />..,?: <br />S <br />s <br />' <br />cBQ <br />' <br />' <br />? <br />? <br /> . <br />nit <br />? «, .,...r,."y .,., <br />? <br />? <br />OJT <br />xG <br />o <br />C? 5T ?U? ? <br /> ^B?VP Level is => 3+ y0`Zo <br /> ?iours of Training are reasonable <br /> ?XCost Computation is in accordance hourly wage 50% of wages or sliding scale <br /> based on number of employees per DOL waiver. <br /> ??Signed by Employer <br />4. Exhibit B: Assurances <br /> `?? <br />5. Exhibit C: Insurance commercial/workers comp for 1,000,000 with Additional ?? ? <br /> Insured Endorsement naming City of Santa Ana as Additional Insured. <br />6. Exhibit D: Drug Free Workplace Form completed and signed. ??? ? <br />7. Exhibit E: Debarment Certification signed. ?? ? <br />8. File: Q/ ? <br /> ADA Survey <br /> EEO 8r Grievance Procedures <br />9. Three copies of agreement and canary routing slip attached ?/ ? <br />Comments: <br />(? ? `--1 ? ( ? ? ? U ? Z? <br />Program Supervisor Date