Medical Certification (1) The University may require an employee to provide medical certification from a health care provider for FMLA leave without pay when taken for the serious health condition of the employee or the employee's family member. (2) Medical certification may be required to affirm the employee's ability to return to work and perform one or more of the essential functions of the job within the meaning of the Americans with Disabilities Act (ADA), after being absent on FMLA leave.
Medical Certificate 🞏 Absent from Work (first date of absence) 🞏 Not absent from work but requires accommodations (Employee Name) The information supplied will be used in a confidential manner and may assist in creating a return to work plan. I hereby consent to the completion of this form by: (Treating Medical Practitioner’s Name) (Signature of Employee) (Date)
Contractor Certification for Contractor Employees Introduction Texas Education Code Chapter 22 requires entities that contract with school districts to provide services to obtain criminal history record information regarding covered employees. Contractors must certify to the district that they have complied. Covered employees with disqualifying criminal histories are prohibited from serving at a school district. Definitions: Covered employees: Employees of a contractor or subcontractor who have or will have continuing duties related to the service to be performed at the District and have or will have direct contact with students. The District will be the final arbiter of what constitutes direct contact with students. Disqualifying criminal history: Any conviction or other criminal history information designated by the District, or one of the following offenses, if at the time of the offense, the victim was under 18 or enrolled in a public school: (a) a felony offense under Title 5, Texas Penal Code; (b) an offense for which a defendant is required to register as a sex offender under Chapter 62, Texas Code of Criminal Procedure; or (c) an equivalent offense under federal law or the laws of another state. I certify that: NONE (Section A) of the employees of Contractor and any subcontractors are covered employees, as defined above. If this box is checked, I further certify that Contractor has taken precautions or imposed conditions to ensure that the employees of Contractor and any subcontractor will not become covered employees. Contractor will maintain these precautions or conditions throughout the time the contracted services are provided. OR SOME (Section B) or all of the employees of Contractor and any subcontractor are covered employees. If this box is checked, I further certify that: (1) Contractor has obtained all required criminal history record information regarding its covered employees. None of the covered employees has a disqualifying criminal history.
Contractor Certification Regarding Ethics The Contractor certifies that the Contractor is now, and shall remain, in compliance with Chapter 42.52 RCW, Ethics in Public Service, throughout the term of this Contract.
Professional Certification The Superintendent shall at all times during the term of this Contract, and any renewal or extension thereof, hold and maintain a valid certificate required of a superintendent by the State of Texas and issued by the State Board for Educator Certification or the Texas Education Agency and any other certificates required by law.
CERTIFICATION OF AGREEMENT In accordance with section 170LT of the Workplace Relations Act 1996, I now certify the attached written agreement. This agreement shall come into force from 16 February 2004 and shall remain in force until 31 October 2005. BY THE COMMISSION: Printed by authority of the Commonwealth Government Printer <Price code 70> TABLE OF CONTENTS Subject Matter Clause No. Page No. Accident Pay 29 32 All-In Payments 34 34 Alpine Areas 14.1.(b) 15 Altona Area Allowance 14.2.(a) 16 Amenities 37 35 Apprentices 22.(a) 23 Australian Materials 41 37 Casual Labour 12.2 13 Classification Structure & Rates of Pay, Allowances 13 14 Clothing Issue & Safety Footwear 40 36 Co-Invest (Long Service Leave) 27 31 Commitments 3 5 Consultation 8 7 Demolition Work 14.1.(d) 16 Dispute Settlement Procedure 9 8 Drugs & Alcohol 38 35 Employment & Termination 12 12 Fares & Travel Allowance 15 17 Fast Food Allowance 14.1.(a) 15 Further Flexibilities 23 24 Geelong, Altona, Portland, etc Metals Agreements 14.3 16 Geographic Area, and Sector Specific Allowances, Conditions and Exceptions 14 15 Hearing Tests 11.(2) 10 Heavy Blocks 11.(9) 12 Hours Of work, Rostered Days Off, and Protection of Leisure Time 17 17 Inclement Weather 24 24 Income Protection 28.1 31 Income Protection & Trauma Insurance 28 31 Induction Procedures 11.(4) 11 Job Stewards/Delegates 36 34 Job Xxxxxxx/Delegate Facilities 36.2 35 Journey Accidents 30 32 Latrobe Valley Allowance 14.2.(b) 16 Leisure Time Protected 17.3 18 Living Away from Home Allowance 16 17 Major Events 14.1.(c) 15 Metal Trades Labour Hire Agreement 14.4 16 Negotiation of a Subsequent Agreement 43 37 No Extra Claims 44 38 Objectives of the Agreement 2 5 Overtime 17.2 18 Parties and Persons Bound 4 6 Payment of Wages 19 21 Period of Operation 6 6 Picnic Day 31 33 Project Agreements 5.2 6 Project Pre-Commencement Conference 18 21 Protective Clothing & Equipment 11.(3) 10 Pyramid Subcontracting 35 34 Redundancy 25 30 Rehabilitation Program 39 35 Relationship to Parent Award and Victorian Building Industry Agreement 7 6 Right of Entry & Representation 33 33 Rostered Days Off 17.4 19 Safety Dispute Resolution 10 8 Scope & Application 5 6 Security & Continuity of Employment 32 33 Service Core Allowance 14.2.(c) 16 Signatories 45 39 Superannuation 26 30 Termination of Employment 12.3 13 Time & Wages Records 19.1 21 Title 1 5 Tool Storage 20 22 Toxic Substances 11(8) 11 Training & Related Matters 22 23 Trauma Insurance 28.2 32 Waste Minimisation, Recycling and Environmental Issues 42 37 Workplace Safety 11 10 Appendix A – Classification Structure 40 Appendix B – Rates of Pay 1. From 1 December 2002 2. From 1 March 2003 3. From 1 March 2004 4. From 1 March 2005 41 Appendix C – Site Allowances 51 Appendix D – Drugs & Alcohol Policy 54 Appendix E – Passenger and Material Lifts 61 Appendix F – Amenities 63 Appendix G – Shopping Centres 66 Appendix H – Trade Union Training Leave 67 Appendix I – Sector Appendix 70
Resume Self-Certification Form When submitting a response to an RFQ the Contractor shall submit with its response a completed and signed Resume Self-Certification Form (Contract Exhibit F) to the Customer for each proposed Staff member identified in the RFQ response.
Certification of Non-Foreign Status Each Limited Partner or transferee of an Interest or a portion of an Interest from a Limited Partner who or that is admitted to the Partnership in accordance with this Agreement will certify, upon admission to the Partnership and at any other time as the General Partner may request, whether the Limited Partner or transferee is a “United States Person” within the meaning of the Code on forms to be provided by the Partnership, and will notify the Partnership within 30 days of any change in the status of the Limited Partner or transferee. Any Limited Partner or transferee who or that fails to provide certification when requested to do so by the General Partner may be treated as a non-United States Person for purposes of U.S. Federal tax withholding.
Certification Regarding Termination of Contract for Non-Compliance (Tex Gov. Code 552.374)
Annual Certification The Contractor is required to submit an annual certification demonstrating compliance with the Warranty of Security to the Department by December 31 of each Contract year.
