NOTE TO PARTICIPANT. If the aggregate Exercise Price of the Option (that is, the Exercise Price multiplied by the Number of Option Shares) plus the aggregate exercise price of any other Incentive Stock Options you hold (whether granted pursuant to the Plan or any other stock option plan of the Participating Company Group) is greater than $100,000, you should contact the Chief Financial Officer of the Company to ascertain whether the entire Option qualifies as an Incentive Stock Option.)
NOTE TO PARTICIPANT. If the Option is exercised more than three (3) months after the date on which you cease to be an Employee (other than by reason of your death or permanent and total disability as defined in Section 22(e)(3) of the Code), the Option will be treated as a Nonstatutory Stock Option and not as an Incentive Stock Option to the extent required by Section 422 of the Code.
NOTE TO PARTICIPANT. Any conflicts of interest or other disclosures to be made by Participant at the time of signing this Agreement shall be set forth on a Conflicts of Interest Disclosure Statement attached to this Agreement. Participant has not made any disclosures if there is no such statement attached. There is is not a Conflicts of Interest Disclosure Statement attached to this Agreement. Participant’s Initials: JL
NOTE TO PARTICIPANT. I (a) authorize the above Training Provider to release any and all information regarding my training, progress, or participation to CareerSource Suncoast (CSS) without further notice or release;(b) understand and accept that the textbooks, uniforms, equipment, supplies etc. purchased by CSS shall remain the property of CSS while I am attending training and until I enter a training related job;(c) agree to make twice monthly contact with my career counselor; and; (d) agree to bring this ITA scholarship voucher to my training provider within the time period allowed by said provider or to be prepared to cover training expenses out-of-pocket Notes: Pell covers living expenses and WIOA covers tuition. *An equal opportunity employer/program. Auxiliary aids and services are available upon request to individuals with disabilities. TTY: dial 711 Participant Signature: Date: Career Counselor: Date: Suncoast Technical College (STC) 0000 Xxxxxx Xxxx Xxxxxxxx, XX 00000 (941) 924-1365 PELL Eligible (Y/N) Credential SOC Code CIP Code Clock Hours Total Program Cost Graduation Rate Placement Rate Average Wage at Placement Basic Skills Grade Level R / M / L xxx.xxxxxxxx.xxx Accounting Operations Y Cert 43.3031 52.0302 800 $ 4,684 80% 88% $ 21.31 10/10/10 Advanced Manufacturing & Production Technology Y Cert 51.1011 52.0205 600 $ 1,922 100% 100% $ 20.25 9/9/9 Automotive Service Technology Y Cert 49.3023 47.0604 1800 $ 9,833 78% 83% $ 17.82 9/10/9 Building Trades & Construction Design Technology Y Cert 49.9071 46.0401 150 $ 6,932 33% 100% $ 17.96 9/9/9 Business Administration Management Y Cert 11.1021 52.0201 900 $ 4,959 33% 100% $ 17.96 9/9/9 Computer-Aided Drawing and Modeling(CAD) Y Cert 17.3019 15.1302 1200 $ 4,447 60% 100% $ 16.78 9/9/9 CNC Production Specialist Y Cert 51.4041 48.0503 600 $ 3,500 50% 100% $ 20.90 9/10/9 Computer Systems & Information Technology Y Cert 11.3021 11.0901 900 $ 3,375 56% 30% $ 25.25 9/10/9 Correctional Officer Y Cert 33.3012 43.0102 420 $ 3,428 100% 100% $ 21.63 9/9/9 Crossover from Corr Officer to Law Enf Officer N Cert 33.3051 43.0107 518 $ 2,455 100% 100% $ 24.00 10/10/10 Professional Culinary Arts-Food Service Manager Y Cert 11.9051 12.0503 1200 $ 6,440 67% 100% $ 19.91 9/9/9 Digital Design Y Cert 27.1024 50.0409 1200 $ 5,308 69% 91% $ 22.64 9/9/9 Digital Video Technology Y Cert 27.4011 10.0201 900 $ 3,893 67% 100% $ 17.76 9/9/9 Electrician Y Cert 47.2111 46.0302 1200 $ 5,853 78% 86% $ 18.24 9/9/9 Facial Specialty N Cert 39.5094 12.0409 4...
NOTE TO PARTICIPANT. I (a) authorize the above Training Provider to release any and all information regarding my training, progress, or participation to CareerSource Suncoast (CSS) without further notice or release;(b) understand and accept that the textbooks, uniforms, equipment, supplies etc. purchased by CSS shall remain the property of CSS while I am attending training and until I enter a training related job;(c) agree to make twice monthly contact with my career counselor; and; (d) agree to bring this ITA scholarship voucher to my training provider within the time period allowed by said provider or to be prepared to cover training expenses out-of-pocket Notes: Pell covers living expenses and WIOA covers tuition. *An equal opportunity employer/program. Auxiliary aids and services are available upon request to individuals with disabilities. TTY: dial 711 Participant Signature: Date: Career Counselor: Date: Attachment B Attachment C ASSURANCES AND CERTIFICATIONS Suncoast Workforce Board, Inc., doing business as CareerSource Suncoast The “Assurances and Certifications” document is needed in certain circumstances for obligations of federal funds for payment of contracts, purchases and services. This certification is a prerequisite, and material representation of fact upon which reliance is placed, for CareerSource Suncoast to enter into an agreement. The submittal of false information may result in the immediate termination of the agreement(s). To reduce the size of the Agreement entered into between CareerSource Suncoast and Contractor, several common government laws and regulations within the Uniform Guidance, 2 CFR, Part 200-Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards, Appendix II Contract Provision which may be applicable shall be incorporated by reference only. The full text of these contract items may be obtained through the Internet or this office. The following laws and regulations are hereby incorporated by reference: • Equal Employment Opportunity Act: The contractor shall comply with Executive Order 11246, Equal Employment Opportunity Act, as amended by Executive Order 11375 and others, and as supplemented in Department of Labor regulation 41 CFR, Part 60 and 45 CFR, Part 92, if applicable. • Debarment and Suspension (E.O.'s 12549 and 12689) —No contract shall be made to parties listed on the General Services Administration's List of Parties Excluded from Federal Procurement or Non-procurement Programs in accordanc...
NOTE TO PARTICIPANT. I (a) authorize the above Training Provider to release any and all information regarding my training, progress, or participation to CareerSource Suncoast (CSS) without further notice or release;(b) understand and accept that the textbooks, uniforms, equipment, supplies etc. purchased by CSS shall remain the property of CSS while I am attending training and until I enter a training related job;(c) agree to make twice monthly contact with my career counselor; and; (d) agree to bring this ITA scholarship voucher to my training provider within the time period allowed by said provider or to be prepared to cover training expenses out-of-pocket Notes: Pell covers living expenses and WIOA covers tuition. *An equal opportunity employer/program. Auxiliary aids and services are available upon request to individuals with disabilities. TTY: dial 711 Participant Signature: Date: Career Counselor: Date: ATTACHMENT B Xxxxx College of Nursing 00000 Xxxxxxxxx Xxxx. N. St. Petersburg, FL 00000 (000) 000-0000 *Includes Sarasota and Pinellas County Locations PELL Eligible (Y/N) Credential SOC Code CIP Code Clock Hours Total Program Cost Graduation Rate Placement Rate Average Wage at Placement Basic Skills Grade Level R / M / L xxx.xxxxxxxxxxxx.xxx/ Associate Degree in Nursing - LPN to RN Bridge Y AS/RN 29.1141 51.3801 99 $ 38,710 71% 73% $ 31.51 11/11/11 Associate Degree in Nursing (AS) Two-Year Option Y AS/RN 29.1141 51.3801 107 $ 50,330 61% 74% $ 28.35 11/11/11 Baccalaureate Degree in Nursing (BSN), Pre-licensure Opt Y RN 29.1141 51.3801 160 $ 76,195 No Data 69% $ 28.04 11/11/11 Practical Nursing(PN) Diploma(Pinellas County Only) Y Cert 29.2061 51.3901 1440 $ 22,601 54% 64% $ 21.86 11/11/11 Attachment C ASSURANCES AND CERTIFICATIONS Suncoast Workforce Board, Inc., doing business as CareerSource Suncoast The “Assurances and Certifications” document is needed in certain circumstances for obligations of federal funds for payment of contracts, purchases and services. This certification is a prerequisite, and material representation of fact upon which reliance is placed, for CareerSource Suncoast to enter into an agreement. The submittal of false information may result in the immediate termination of the agreement(s). To reduce the size of the Agreement entered into between CareerSource Suncoast and Contractor, several common government laws and regulations within the Uniform Guidance, 2 CFR, Part 200-Uniform Administrative Requirements, Cost Principles, and Audit Requirements f...
