File Name: Template_LW 6 - Employee Information Form.pdf
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LW-6 LWO – EMPLOYEE INFORMATION FORM REQUIRED DOCUMENTATION FOR ALL CONTRACTS SUBJECT TO LWOThis form must be submitted to the AWARDING DEPARTMENT within 30 DAYS of contractexecution. INCOMPLETE SUBMISSIONS WILL BE RETURNED
THE LIVING WAGE ORDINANCE (LWO) REQUIRES THAT SUBJECT EMPLOYERS PROVIDE TO EMPLOYEES: As of July 1, 2017, a wage of at least $11.48 per hour with health benefits of $1.25 per hour, or $12.73 per hour without health benefits (to be adjusted annually on July 1); At least 96 compensated hours off per year for sick leave, vacation or personal necessity at the employee’s request (pro-rated for part-time employees); and At least 80 additional hours off per year of uncompensated time off for personal or immediate family illness(pro- rated for part-time employees). Refer to the LWO Rules and Regulations, available on the Bureau of Contract Administration website at http://bca.lacity.org/living-wages-ordinance-lwo, for details regarding the wage and benefit requirements of the Ordinance; and Information of their possible right to the federal Earned Income Tax Credit (EITC) and make available the forms required to secure advance EITC payments from the employer
THE LIVING WAGE ORDINANCE (LWO) ALSO REQUIRES EMPLOYERS: Not to retaliate against any employee claiming non-compliance with the provisions of this Ordinance and to comply with federal law prohibiting retaliation for union organizing
TO BE FILLED OUT BY THE CONTRACTOR: 1. Company Name: Email Address: 2. STATE the number of employees working ON THIS CITY CONTRACT: st 3. ATTACH a copy of your company’s 1 PAYROLL under THIS CITY CONTRACT
4. Do you provide health benefits (such as medical, dental, vision, mental health, and disability insurance) to your employees? Yes No If YES, provide the employer's monthly contribution amount(s) toward the health benefits premium(s) for each employee working on THIS CITY CONTRACT
FAILURE TO COMPLY WITH THESE REQUIREMENTS WILL RESULT IN WITHHOLDING OF PAYMENTS BY THE CITY CONTROLLER, OR A RECOMMENDATION TO THE AWARDING AUTHORITY FOR CONTRACT TERMINATION
ALL INFORMATION SUBMITTED IS SUBJECT TO VERIFICATION, AND FALSE INFORMATION MAY RESULT IN CONTRACT TERMINATION
I understand that the employee information provided herein will be used by the City of Los Angeles, Office of Contract Compliance for the purpose of monitoring the Living Wage Ordinance
Print Name of Person Completing this Form Signature of Person Completing this Form Title Phone # Date AWARDING DEPARTMENT USE ONLY: Dept: Contact: Phone #: Contract #:Form OCC/LW-6, Rev. 07/17 OFFICE OF CONTRACT COMPLIANCE, EEOE SECTION: (213) 847-2625
Lwo – employee information form . required documentation for all contracts subject to lwo . this form must be submitted to the awarding department within 30 days of contract execution. …
Fir Airline Food Caterers, the LWO may be superseded by a CBA for only when an employee is receiving a total economic package no less than the wage and health benefits required by the LWO. As of July 1, 2019, the cash wage will increase to $15.25 and the health benefits will increase to $5.34.
The LWO may be superseded by a collective bargaining agreement (CBA) for employers servicing the Airport only when an employee is paid a wage not less than the applicable wage rate.
Please visit Public Works’ website or contact the Bureau of Contract Administration, Office of Contract Compliance, 1149 S. Broadway St., Suite 300, Los Angeles, CA 90015, phone: (213) 847-1922, and fax: (213) 847-2777; for the most current LWO and SCWRO rates, language, and regulations.