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HR Documents
Name
Date
Download
2019 Health Rates (Bay Area)
September 7, 2018
PDF (105 KB)
2019 Health Rates (Northern)
September 7, 2018
PDF (53 KB)
2019 Health Rates (Sacramento)
September 7, 2018
PDF (194 KB)
2019 Summary of Benefits and Coverage Notice
December 18, 2018
PDF (101 KB)
2020 Holiday Schedule
August 7, 2019
PDF (61 KB)
2023 Holiday Schedule
October 17, 2022
PDF (163 KB)
2023 Payroll Calendar
January 3, 2022
PDF (97 KB)
457 Plan Catch-Up Brochure- MissionSquare
October 7, 2021
PDF (133 KB)
Acknowledgement of Receipt- Job Description
January 10, 2019
PDF (152 KB)
Alternate Work Schedule FAQs
November 17, 2017
DOC (45 KB)
Alternate Work Schedule Request
November 17, 2017
PDF (97 KB)
Alternate Work Schedule Request Agreement
November 17, 2017
PDF (153 KB)
Beneficiary Designation form for Basic and/or Voluntary Life Insurance
April 4, 2019
PDF (24 KB)
Benefits at Termination of Employment
November 17, 2017
PDF (121 KB)
Best practices for supporting & retaining your volunteers
September 28, 2018
PDF (92 KB)
CalPERS Health Enrollment Form (HBD-12)
January 21, 2020
PDF (360 KB)
CalPERS Pharmacy Changes 2021
October 27, 2020
PDF (99 KB)
CalPERS Reciprocity Form
September 13, 2019
PDF (63 KB)
Catastrophic Leave Policy
May 22, 2018
PDF (276 KB)
Catastrophic Leave Program Donation Form
April 22, 2020
PDF (96 KB)
Catastrophic Leave Program Recipient Acknowledgement Form
April 22, 2020
PDF (104 KB)
Cesar Chavez Closure Template
March 22, 2022
DOCX (34 KB)
Choose your Contribution- MissionSquare
October 7, 2021
PDF (69 KB)
City Hall Access Request Cover Sheet
August 19, 2020
PDF (119 KB)
Computer Loan Policy
December 5, 2018
PDF (198 KB)
Confidential Agreement- Volunteers
September 28, 2018
PDF (175 KB)
Corrective Discipline Policy
May 22, 2018
PDF (666 KB)
Dependent Care Eligible Expenses
December 8, 2020
PDF (82 KB)
Drug & Alcohol Policy (Non-DOT) Acknowledgement Form
January 27, 2020
PDF (118 KB)
EAP Brochure – City of San Rafael
August 22, 2019
PDF (1.2 MB)
EAP Concern Introduction
January 4, 2022
PDF (805 KB)
EAP Concern Registration Instructions
January 4, 2022
PDF (1.6 MB)
EAP Discount Center Flyer
September 13, 2019
PDF (424 KB)
EAP First Responder Program
January 4, 2022
PDF (464 KB)
EAP Overview
August 22, 2019
PDF (180 KB)
EAP Providers in Northern CA
March 4, 2020
PDF (285 KB)
Elements of Volunteer Job Design
September 28, 2018
PDF (68 KB)
Employee Emergency Information Form
September 18, 2018
PDF (135 KB)
Employee Offboarding Checklist
November 19, 2019
PDF (112 KB)
Employee Recognition Program- Nomination Form
September 28, 2018
PDF (217 KB)
Employer-Employee Relations Resolution
November 17, 2017
PDF (102 KB)
Executives, Mid-Mgmt & Electeds
September 7, 2018
DOCX (46 KB)
Executives, Mid-Mgmt & Electeds (Sacramento)
September 7, 2018
DOCX (283 KB)
Executives, Mid-Mgmt & Electeds Cafeteria Plan Form 2020
September 10, 2019
PDF (265 KB)
Federal Employee’s Withholding (W-4)
March 3, 2020
PDF (177 KB)
Final Paycheck & Benefits Information
December 21, 2022
PDF (127 KB)
Fire Chiefs’ Cafeteria Plan Form 2020
September 10, 2019
PDF (278 KB)
First Responders Benefit Summary
January 4, 2022
PDF (252 KB)
Fixed-Term
September 7, 2018
DOCX (283 KB)
Fixed-Term (Exempt)
September 7, 2018
DOCX (283 KB)
Fixed-Term Cafeteria Plan Form 2020
September 10, 2019
PDF (293 KB)
Fixed-Term EXEMPT Cafeteria Plan Form 2020
September 10, 2019
PDF (270 KB)
Form 5020
April 27, 2018
PDF (481 KB)
FSA Brochure
December 17, 2018
PDF (1 MB)
FSA Brochure- Spanish
December 17, 2018
PDF (991 KB)
FSA Eligible Expenses
December 17, 2018
PDF (389 KB)
FSA Handbook
December 17, 2018
PDF (1 MB)
Gym Reimbursement Form
June 14, 2019
PDF (136 KB)
Gym Reimbursement Informational Sheet
June 14, 2019
PDF (126 KB)
Harassment Policy
May 22, 2018
PDF (266 KB)
Health Insurance Portability and Accountability Act (HIPPA) Form
February 12, 2020
PDF (304 KB)
Hep B Form
August 19, 2020
PDF (121 KB)
HEP B-Exposure Determination List by Dept/Job Class
January 25, 2019
PDF (97 KB)
How to Rollover Your Money- MissionSquare
October 7, 2021
PDF (101 KB)
HR- Approval Process for All New Hires
December 30, 2021
PDF (216 KB)
Human Resources Portal Instructions
May 30, 2018
PDF (425 KB)
I-9 Employment Eligibility Verification
February 27, 2020
PDF (253 KB)
I-9 Instructions
February 27, 2020
PDF (600 KB)
ICMA – 457 Designation of Beneficiary Form
June 7, 2018
PDF (361 KB)
ICMA – Roth IRA Enrollment Form
August 28, 2020
PDF (2 MB)
ICMARC- Name Change FAQ
April 1, 2021
PDF (135 KB)
ID Card Request Form
March 25, 2020
PDF (355 KB)
IIPP
May 22, 2018
PDF (7 MB)
Independence Day Closure Flyer
March 22, 2022
DOCX (34 KB)
Industrial Injury Medical Panel
December 11, 2023
PDF (167 KB)
Job Action Checklist & Routing Slip
September 9, 2021
PDF (138 KB)
Job Action Checklist and Routing Slip
November 17, 2017
PDF (159 KB)
Juneteenth Closure Template
March 22, 2022
DOCX (34 KB)
Labor Day Closure Template
March 22, 2022
DOCX (34 KB)
Legal-Financial- ID Theft Flyer
September 13, 2019
PDF (92 KB)
LWP Memo to All Employees
April 27, 2018
PDF (438 KB)
Martin Luther King Jr. Birthday Closure Template
March 22, 2022
DOCX (34 KB)
MCERA Beneficiary Change Form
November 15, 2017
PDF ()
MCERA Membership Enrollment Form
November 15, 2017
PDF ()
MCERA Name Change Form
November 15, 2017
PDF ()
MCERA Name Change Form
April 10, 2020
PDF (86 KB)
MCERA Welcome Guide
September 13, 2019
PDF (408 KB)
Memorial Day Closure Template
March 22, 2022
DOCX (34 KB)
MES Summary of Benefits
October 8, 2018
PDF (134 KB)
MES- Certificate of Coverage
March 14, 2020
PDF (466 KB)
MissionSquare Contribution Change Form
January 11, 2021
PDF (90 KB)
MissionSquare ROTH IRA Enrollment Form
May 12, 2020
PDF (912 KB)
Nationwide Enrollment Form
January 25, 2019
PDF (1.4 MB)
Nationwide Rollover Request Form
February 7, 2020
PDF (139 KB)
Nationwide- Payroll Card
January 25, 2019
PDF (1 MB)
New Employee Onboarding Checklist (For Supervisors/Department Admin)
March 8, 2021
DOCX (49 KB)
New Hire Checklist- Fixed-Term
January 30, 2019
PDF (35 KB)
New Hire Checklist- Regular PT less than 75% FTE
January 30, 2019
PDF (35 KB)
New Hire Checklist- Temporary & Seasonal
January 30, 2019
PDF (173 KB)
New Hire Checklist- Unrepresented Executives/Management
January 30, 2019
PDF (35 KB)
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