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On the Job Training Agreement Checklist <br />BUSINESS NAME: ?" ?`C? ??iYlC:e/?eji'L <br />YES NO <br />1 . Pre Award Survey ? ? <br />2. OJT Agreement Template: Training dates (pg 1), reimbursement rate (pg 1), and `6Q ? <br />maximum reimbursement amount (pg 4), and Employer Info (pg 5) match Exhibit /- <br />A-Training Plan. <br />3. Exhibit A: Training Plan <br />?OJT's to employees do not exceed 1-5 ratio `? ? <br />SVP Level is => 3+ / <br />Hours of Training are reasonable <br />r?!,n'r`.•ost Computation is in accordance hourly wage 50% of wages or sliding scale <br />based on number of employees per DOL waiver. <br />C1?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: <br />AD <br />S ? ? <br /> A <br />urvey <br /> EEO 8t Grievance Procedures <br />9. Three copies of agreement and canary routing slip attached ? ? <br />Comments: <br />C;6?? ?-?1?,1,? <br />Program Supervisor Date