CITY OF SAN RAFAEL



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HARASSMENT POLICY

ACKNOWLEDGEMENT OF RECEIPT

I acknowledge receipt of the City’s Policy Against Harassment, Discrimination and Retaliation.

I understand that I am responsible for reading, understanding and complying with this policy and all standards of conduct referenced and contained in this document.

Employee Name:

(Printed name - Last, First and Middle Initial)

Employee Signature:

Department:

Date:

This form must be returned to the Human Resources Department as soon as possible and no later than two weeks after receipt of the policy

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