Attachments for 06-07 RFCR for WorkSource contractors
|Contractor: | |
| |Completion Status |Guidelines |
|Form 1 | |Please include completed checklist with RFCR submission |
|RFCR Document Checklist |Completed: | |
|Form 2 | |Please include the completed Contractor General |
|Contractor General Information |Completed: |Information Form with RFCR submission. |
|Corporate Documents |No Change: |If there have been any changes to your Agency’s Legal |
| | |Name, Corporate Status, City Business License Number, IRS|
| |Revised and attached: |Taxpayer Identification Number, Articles of |
| |Agency Legal Name |Incorporation, or Corporate Bylaws, or DUNS number, |
| |Corporate Status |submit the revised documents with this RFCR or select No |
| |City Business License Number |Change. |
| |IRS Taxpayer Identification Number | |
| |Articles of Incorporation | |
| |Corporate Bylaws | |
| |DUNS# | |
|Code of Conduct | | |
| |Adopted the Code of Conduct provided| |
| |by the City of Los Angeles; or | |
| | | |
| |Agency has own Code of Conduct | |
| |Approved by the City | |
| | | |
| |Submitting Code of Conduct | |
|Form 5 |Completed: | |
|Budget Forms | | |
|Form 6 |Completed: | |
|Budget Narrative Form | | |
|Budget Support Documentation |Completed: | |
|(See Section X) | | |
|Form 7A |Form 50 Attached: |Please include original Certification Compliance Form |
|Bidder Certification Certificate of Compliance | |with wet signatures |
|Form 50 | | |
| | |CEC Form 50 can be downloaded at |
| | | |
|Form 7B |Form 55 Attached: |Please include original Certification Compliance Form |
| | |with wet signatures |
|Bidder Contributions | | |
|CEC Form 55 | |CEC Form 55 can be found on the Ethics Commission's |
| | |website, on the Forms page, or by clicking this link: |
| | |
| | |df |
|Form 8 |Attached: |Please include original Certification of Authorities with|
|Certification of Authorities | |wet signatures |
|Form 9 |Attached: |Please include Board Resolution and Certification |
|Board Resolution and Certification (sample) | | |
|Form 10 |Updated list |Please include updated list of |
|Resolution Identifying Members of Board of |Attached: |Board Members along with Certification of Board |
|Directors (sample) |Resolution Attached: |Resolution. |
|Form 11 |Attached: |Please attach completed Inventory Form if applicable. |
|Equipment Inventory Form | | |
|Form 12 |Attached: |Please attach a completed CRO Questionnaire. |
|Contractor Responsibility Ordinance (CRO) | | |
|Service Questionnaire | |The CRO Service Questionnaire can be downloaded at |
| | |
| | |ionnaire%20Rev%201-20-12.pdf |
|Form 13 |Attached: |Please attach a completed and signed CRO Pledge of |
|CRO Pledge of Compliance | |Compliance. |
| | | |
| | |The CRO Pledge can be downloaded at |
| | |
| | |mpliance.PDF |
|Forms 11 |Attached: |Please refer to the attached LWO Submission Guidelines, |
|Living Wage Ordinance (LWO) | |complete and attach the appropriate LWO forms. |
|Submission Guidelines | | |
| | |LWO forms can be downloaded at |
|Guideline 1 |Registered: |Please refer to the attached instructions to register on |
|Los Angeles Business Assistance Virtual Network| |BAVN. Upload the applicable ordinance forms: EEP, AA, |
|(BAVN) “Download Templates” Instructions | |EBO, and SDO (Guidelines 1a—1d). |
| | | |
| | |IMPORTANT: If you have uploaded and received approvals on|
| | |the above referenced ordinance forms within the last 12 |
| | |months, no action is necessary. Instead, please select |
| | |the “Uploaded” boxes on Guidelines 1a-1d, wherever |
| | |applicable. Approved BAVN ordinance forms remain in |
| | |effect for 12 months for any number of contracts. |
| | | |
| | |For more details please go to |
|Guideline 1a |Uploaded: |Please upload the completed EBO/FHSO form at |
|Equal Benefits Ordinance (EBO) and First Source|Date Uploaded:______ | if you have not done so within the last 12|
|Hiring Ordinance (FSHO) Compliance Affidavits | |months. |
|Guideline 1b |Uploaded: |Please upload the completed SDO form at if|
|Slavery Disclosure Ordinance (SDO) Affidavit |Date Uploaded:______ |you have not done so within the last 12 months. |
|Guideline 1c |Uploaded: |Please upload the completed EBO/FHSO form at |
|Affirmative Action Program Affidavit |Date Uploaded:______ | if you have not done so within the last 12|
| | |months. |
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