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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)
2022 Holiday Schedule January 3, 2022 PDF (210 KB)
2022 Payroll Calendar September 12, 2018 PDF (244 KB)
2023 Holiday Schedule October 17, 2022 PDF (163 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 Agreement September 14, 2018 PDF (117 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)
Direct Deposit Authorization Form February 7, 2020 PDF (114 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 November 5, 2019 PDF (124 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 April 27, 2018 PDF (162 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 April 10, 2020 PDF (86 KB)
MCERA Name Change Form November 15, 2017 PDF ()
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 Contribution Change Form for 2022 November 22, 2021 PDF (105 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 July 28, 2021 DOCX (99 KB)
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