Documentation for Nondiscrimination in Benefits. (Questions 2c and 2d only) If you answered “yes” to any part of Question 2c or Question 2d, you must attach to this form those provisions of insurance policies, personnel policies, or other documents you have which verify your compliance with Question 2c or Question 2d. Please include the policy sections that list the benefits for which you indicated “yes” in Question 2c. If documentation does not exist, attach an explanation, e.g., some of your personnel policies are unwritten. If you answered “yes” to Question 2d(1) complete and attach form SFRA/CC-103, “Nondiscrimination in Benefits— Reasonable Measures Affidavit,” which is available from the Agency. You need not document your “yes” answer to Question 1a or Question 1b.
Documentation for Nondiscrimination in Benefits. (Questions 2c and 2d only) If you answered "yes" to any part of Question 2c or Question 2d, you must attach to this form those provisions of insurance policies, personnel policies, or other documents you have which verify your compliance with Question 2c or Question 2d. Please include the policy sections that list the benefits for which you indicated "yes" in Question 2c. If documentation does not exist, attach an explanation, e.g., some of your personnel policies are unwritten. If you answered "yes" to Question 2d (1) complete and attach form SFRA/CC-103, "Nondiscrimination in Benefits— Reasonable Measures Affidavit," which is available from the Agency. You need not document your "yes" answer to Question la or Question lb. I declare (or certify) under penalty of perjury that the foregoing is true and correct, and that I am authorized to bind this entity contractually. Executed this day of , 200 , at (City) (State) Name of Company/Organization: Doing Business As (DBA): Also Known As (AKA): General Address: (For General Correspondence) Remittance Address: (If different from above address) Name of Signatory: Title: (Please Print) Signature: Phone Number: Federal Tax Identification Number: Approximate number of employees in the U.S.: Vendor Number: (if known) ❑ Check here if your address has changed. ❑ Check here if your organization is a non-profit. ❑ Check here if your organization is a governmental entity. THIS FORM MUST BE RETURNED WITH THE ORIGINAL SIGNATURE Please return this form to: Successor Agency to Redevelopment Agency, Xxx Xxxxx Xxx Xxxx Xxx, 5th Floor, San Francisco, CA 94103 Exhibit E Small Business Enterprise Program SMALL BUSINESS ENTERPRISE AGREEMENT The company or entity executing this Small Business Enterprise Agreement, by and through its duly authorized representative, xxxxxx agrees to use good faith efforts to comply with all of the following:
Documentation for Nondiscrimination in Benefits. (Questions 2c and 2d only) If you answered to any part of Question 2c or Question 2d, you must attach to this form those provisions of insurance policies, personnel policies, or other documents you have which verify your compliance with Question 2c or Question 2d. Please include the policy sections that list the benefits for which you indicated in Question 2c. If documentation does not exist, attach an explanation, e.g., some of your personnel policies are unwritten. If you answered to Question 2d(1) complete and attach form SFRA/CC-103, ondiscrimination in Benefits Reasonable Measures which is available from the Agency. You need not document your answer to Question 1a or Question 1b.
Documentation for Nondiscrimination in Benefits. (Questions 2c and 2d only)
