| 2019 Health Rates (Bay Area) |
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September 7, 2018 |
PDF (105 KB)
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| 2019 Health Rates (Northern) |
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September 7, 2018 |
PDF (53 KB)
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| 2019 Health Rates (Sacramento) |
|
September 7, 2018 |
PDF (194 KB)
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| 2019 Summary of Benefits and Coverage Notice |
|
December 18, 2018 |
PDF (101 KB)
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| 2020 Holiday Schedule |
|
August 7, 2019 |
PDF (61 KB)
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| 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)
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| Acknowledgement of Receipt- Job Description |
|
January 10, 2019 |
PDF (152 KB)
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| Alternate Work Schedule FAQs |
|
November 17, 2017 |
DOC (45 KB)
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| Alternate Work Schedule Request |
|
November 17, 2017 |
PDF (97 KB)
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| Alternate Work Schedule Request Agreement |
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November 17, 2017 |
PDF (153 KB)
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| Beneficiary Designation form for Basic and/or Voluntary Life Insurance |
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April 4, 2019 |
PDF (24 KB)
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| Benefits at Termination of Employment |
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November 17, 2017 |
PDF (121 KB)
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| Best practices for supporting & retaining your volunteers |
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September 28, 2018 |
PDF (92 KB)
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| CalPERS Health Enrollment Form (HBD-12) |
|
January 21, 2020 |
PDF (360 KB)
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| CalPERS Pharmacy Changes 2021 |
|
October 27, 2020 |
PDF (99 KB)
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| CalPERS Reciprocity Form |
|
September 13, 2019 |
PDF (63 KB)
|
| Catastrophic Leave Policy |
|
May 22, 2018 |
PDF (276 KB)
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| Catastrophic Leave Program Donation Form |
|
April 22, 2020 |
PDF (96 KB)
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| Catastrophic Leave Program Recipient Acknowledgement Form |
|
April 22, 2020 |
PDF (104 KB)
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| Cesar Chavez Closure Template |
|
March 22, 2022 |
DOCX (34 KB)
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| Choose your Contribution- MissionSquare |
|
October 7, 2021 |
PDF (69 KB)
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| City Hall Access Request Cover Sheet |
|
August 19, 2020 |
PDF (119 KB)
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| Computer Loan Policy |
|
December 5, 2018 |
PDF (198 KB)
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| Confidential Agreement- Volunteers |
|
September 28, 2018 |
PDF (175 KB)
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| Corrective Discipline Policy |
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May 22, 2018 |
PDF (666 KB)
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| Dependent Care Eligible Expenses |
|
December 8, 2020 |
PDF (82 KB)
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| Drug & Alcohol Policy (Non-DOT) Acknowledgement Form |
|
January 27, 2020 |
PDF (118 KB)
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| EAP Brochure – City of San Rafael |
|
August 22, 2019 |
PDF (1.2 MB)
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| EAP Concern Introduction |
|
January 4, 2022 |
PDF (805 KB)
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| EAP Concern Registration Instructions |
|
January 4, 2022 |
PDF (1.6 MB)
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| EAP Discount Center Flyer |
|
September 13, 2019 |
PDF (424 KB)
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| EAP First Responder Program |
|
January 4, 2022 |
PDF (464 KB)
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| EAP Overview |
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August 22, 2019 |
PDF (180 KB)
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| EAP Providers in Northern CA |
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March 4, 2020 |
PDF (285 KB)
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| Elements of Volunteer Job Design |
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September 28, 2018 |
PDF (68 KB)
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| Employee Emergency Information Form |
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September 18, 2018 |
PDF (135 KB)
|
| Employee Offboarding Checklist |
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November 19, 2019 |
PDF (112 KB)
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| Employee Recognition Program- Nomination Form |
|
September 28, 2018 |
PDF (217 KB)
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| Employer-Employee Relations Resolution |
|
November 17, 2017 |
PDF (102 KB)
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| Executives, Mid-Mgmt & Electeds |
|
September 7, 2018 |
DOCX (46 KB)
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| Executives, Mid-Mgmt & Electeds (Sacramento) |
|
September 7, 2018 |
DOCX (283 KB)
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| Executives, Mid-Mgmt & Electeds Cafeteria Plan Form 2020 |
|
September 10, 2019 |
PDF (265 KB)
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| Federal Employee’s Withholding (W-4) |
|
March 3, 2020 |
PDF (177 KB)
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| Final Paycheck & Benefits Information |
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December 21, 2022 |
PDF (127 KB)
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| Fire Chiefs’ Cafeteria Plan Form 2020 |
|
September 10, 2019 |
PDF (278 KB)
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| First Responders Benefit Summary |
|
January 4, 2022 |
PDF (252 KB)
|
| Fixed-Term |
|
September 7, 2018 |
DOCX (283 KB)
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| Fixed-Term (Exempt) |
|
September 7, 2018 |
DOCX (283 KB)
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| Fixed-Term Cafeteria Plan Form 2020 |
|
September 10, 2019 |
PDF (293 KB)
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| 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)
|