This internal website is for City of San Rafael employees. The public website is www.cityofsanrafael.org.

HR Documents

NameDateDownload
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)
2020 ICMA Contribution Change Form January 3, 2020 PDF (113 KB)
2020 Payroll Calendar September 12, 2018 PDF (28 KB)
Acknowledgement of Receipt- Job Description January 10, 2019 PDF (113 KB)
Alternate Work Schedule FAQs November 17, 2017 DOC (45 KB)
Alternate Work Schedule Request November 17, 2017 PDF (19 KB)
Alternate Work Schedule Request Agreement November 17, 2017 PDF (23 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 (253 KB)
CalPERS Reciprocity Form September 13, 2019 PDF (63 KB)
Catastrophic Leave Policy May 22, 2018 PDF (276 KB)
Computer Loan Agreement September 14, 2018 PDF (117 KB)
Computer Loan Policy December 5, 2018 PDF (198 KB)
Confidential Agreement- Volunteers September 28, 2018 PDF (214 KB)
Corrective Discipline Policy May 22, 2018 PDF (666 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 Discount Center Flyer September 13, 2019 PDF (424 KB)
EAP Overview August 22, 2019 PDF (180 KB)
Elements of Volunteer Job Design September 28, 2018 PDF (68 KB)
Employee Emergency Information Form September 18, 2018 PDF (65 KB)
Employee Recognition Program- Nomination Form September 28, 2018 PDF (217 KB)
Employee Telephone Directory February 5, 2020 PDF (98 KB)
Employee Termination Checklist November 19, 2019 PDF (313 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)
Final Paycheck & Benefits Information November 5, 2019 PDF (124 KB)
Fire Chiefs’ Cafeteria Plan Form 2020 September 10, 2019 PDF (278 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 Enrollment Form December 17, 2018 PDF (614 KB)
FSA Handbook December 17, 2018 PDF (1 MB)
Gym Reimbursement Form June 14, 2019 PDF (117 KB)
Gym Reimbursement Informational Sheet June 14, 2019 PDF (110 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-Exposure Determination List by Dept/Job Class January 25, 2019 PDF (97 KB)
Human Resources Portal Instructions May 30, 2018 PDF (425 KB)
IIPP May 22, 2018 PDF (7 MB)
Industrial Injury Medical Panel April 27, 2018 PDF (162 KB)
IRS Reimbursement Rates May 14, 2019 PDF (38 KB)
Job Action Checklist and Routing Slip November 17, 2017 DOC (58 KB)
Legal-Financial- ID Theft Flyer September 13, 2019 PDF (92 KB)
LWP Memo to All Employees April 27, 2018 PDF (438 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 Welcome Guide September 13, 2019 PDF (408 KB)
MES Summary of Benefits October 8, 2018 PDF (134 KB)
MES- Certificate of Coverage March 14, 2019 PDF (532 KB)
Nationwide Enrollment Form January 25, 2019 PDF (1 MB)
Nationwide Rollover Request Form February 7, 2020 PDF (139 KB)
Nationwide- Payroll Card January 25, 2019 PDF (1 MB)
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 (91 KB)
New Hire Checklist- Unrepresented Executives/Management January 30, 2019 PDF (35 KB)
New Hire Checklist-Regular Full-Time & Part-Time greater than 75% FTE January 30, 2019 PDF (36 KB)
New Hire Paperwork Checklist January 23, 2019 PDF (84 KB)
Notice of Privacy Practices- HIPPA March 14, 2019 PDF (271 KB)
Opt-Out (Waiver) Attestation Form August 12, 2019 PDF (243 KB)
Orientation & Training of Volunteers Checklist September 28, 2018 PDF (80 KB)
Outside Employment Policy May 22, 2018 PDF (318 KB)
Outside Employment Policy- SRFD September 13, 2018 PDF (1 MB)
Performance Eval – Management / Mid-Management November 17, 2017 DOC (108 KB)
Performance Eval – Non-Management November 17, 2017 DOC (88 KB)
Performance Eval – Temp-Seasonal, Fixed-Term November 17, 2017 DOC (67 KB)
Personnel Action Report (PAR) Instructions September 12, 2018 PDF (170 KB)
Personnel Action Report Form (PAR) January 16, 2020 DOC (97 KB)
Personnel Requisition December 23, 2019 PDF (411 KB)
PEU Local 1- Confidential September 7, 2018 DOCX (284 KB)
PEU- Local 1 (Confidential Unit) Cafeteria Plan Form 2020 September 10, 2019 PDF (273 KB)
Police Mid-Mgmt Cafeteria Plan Form 2020 September 10, 2019 PDF (276 KB)
Position Reclassification Policy May 22, 2018 PDF (426 KB)
Predesignation of Personal Physician April 27, 2018 PDF (138 KB)
Project Planning Form- Neighborhoods September 28, 2018 PDF (12 KB)
Report form for Community Projects September 28, 2018 PDF (68 KB)
Request to Engage in Outside Employment September 13, 2018 PDF (36 KB)
Request to Engage in Outside Employment- Child Care September 14, 2018 PDF (146 KB)
Request to Engage in Outside Employment-SRFD September 13, 2018 PDF (99 KB)
Response to Request for References Policy May 22, 2018 PDF (191 KB)
Rules & Guidelines for Removing Graffiti September 28, 2018 PDF (250 KB)
Rules & Guidelines for Removing Graffiti (Spanish) September 28, 2018 PDF (329 KB)
Safety Action Report January 24, 2019 PDF (44 KB)
Safety Action Report Instructions January 24, 2019 PDF (45 KB)
Safety Poster September 28, 2018 PDF (130 KB)
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