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company name Wellness Reimbursement Request Date. current date Employee. contract first name contract last name Department. department Supervisor. supervisor manager Employee Job Information Position. contract job title Status. Full time N Date of Hire. Work Type. Hourly Salary Shift Type. Day Night Swing Other Instructions. Supervisor must complete the following form and file it with the Human Resources Department. Employee must provide receipt for all reimbursed wellness activities. Description of Wellness Program or Activities Describe the wellness program or activities you are seeking reimbursement for.

Qualifications Does employee have receipt of payment for the activities being submitted for reimbursement. Yes No. Are the activities submitted for reimbursement Qualified Wellness Program activities. Yes No. Qualified Wellness Program Activities Purpose of company name Wellness Reimbursement Plan. The purpose of this plan is to provide our full time employees with financial incentives and assistance to encourage participation in health and wellness activities and programs such as health club memberships aerobic exercise classes health education classes and smoking and tobacco cessation or weight management programs. Who can participate in Wellness Reimbursement. Full time regular employees are eligible to participate in the wellness reimbursement program. The maximum benefit an employee can receive is limited to Insert Amount month for all qualified activities. For an activity to be considered qualified the employee must participate in the activity for three consecutive months to be eligible for reimbursement. The company will also reimburse any previously paid qualified wellness expense so long as it is within six months of the reimbursement request subject to documentation requirements. The following activities shall be excluded from the Wellness Reimbursement plan.

* Recreational sports programs unless included in health club membership dues * Recreational sports events including marathons triathlons tournaments * Personal trainer fees and personal fitness or sports equipment * Classes training or instruction that is not provided by licensed business or instructor proof may be required * Meals supplements or aids for weight loss body building or for smoking tobacco cessation * Massage programs * Medical treatment programs or therapy

* Psychological treatment programs or therapy * Fees finance charges late fees or other charges not part of regular health club or classroom dues Payment Requirements. All reimbursement requests must have paid receipt showing the wellness activity purchased date of purchase the business Tax ID and the period of time that the purchase covers. For multi month purchases made up front company shall reimburse up to Insert Amount month paid on quarterly basis. Company will reimburse only wellness expenses incurred during employment with company name. Expenses prior to employment with company name shall not be considered.

Company reserves the right to request additional information or documentation on all requested reimbursements. Company may also deny reimbursement expense if that expense is determined to be covered under an applicable health insurance plan or other reimbursable program. Employees may not submit wellness reimbursement request for any expense that has already been submitted or paid out through Flexible Spending Account FSA Health Savings Account HSA or Medical Reimbursement Account MRA. If you have any questions concerning the eligibility of any wellness expense please consult the Human Resources Department. Notes. Supervisor Signature Date For Office Use Only Received By signator authorized signature or signer. Human Resources Manager Date Include Employee Contact HR Information address address city state or province zip or postal code

Phone phone number

REIMBURSEMENT OF EXPENSES PLAN ACCOUNTABILITY PLAN Accountability Plan. Declarations and Conditions company name Company wishes to establish an employee expense reimbursement plan by which employees in the employ of Company may be reimbursed for approved expenses or receive advances for specific future expenses so long as those expenses are properly documented and approved prior to disbursement. A reimbursement request shall be deemed appropriate if it meets the following guidelines. * The expense is considered to be necessary and ordinary and is connected to or incurred on behalf of Companys business operations or the performance of an employees normal job functions or travel.

* The expense has been approved by Company and the employees purchase of goods or services is merely for the convenience of Company. * The expense is suitably documented and substantiated and submitted to Company within reasonable period of time. For the purposes of this plan document reasonable period of time shall be considered as submitted for reimbursement within days of when the expense was occurred and paid for by the employee. * Any advanced monies given to employees in excess of what is required are returned to Company within days of disbursement. A reimbursement request that meets the above conditions shall be considered to be covered under the Company accountability plan. All reimbursements shall be excluded from an employees gross pay and shall be remitted to the employee by check or by direct reimbursement as line item on the employees normal paycheck. Accountability Plan. Exceptions Notwithstanding the above the following items shall not be considered to be reimbursable expenses under this plan and may be subject to other Company policies that fall outside of the scope of this accountability plan.

* Insert exclusions here. * Insert exclusions here. * Insert exclusions here. The above listed guidelines constitute the Companys Accountability Plan and in no way limit Companys ability to further limit the amount of monies that an employee may be reimbursed. Company reserves the right to modify this plan at any time or to develop plan limitations on an individual employee basis. Company Officer Name current date

company name CUSTOMER SURVEY Thank you taking the time to fill out this customer survey. Your comments are important to us. Did company name meet your expectations. Yes No If not why not. Would you recommend company name to others. Yes No

If not why not. What is your age range. 18 20 21 30 31 40 41 50 51 60 60+ What is your annual household income range. Less than 25 25 40 40 60 60 80 80 100 100 + What is your marital status. Single Married Divorced Widowed

What is your race. White non Hispanic Hispanic African American Asian Pacific Islander Native American What is your level of education. High School 2 Years College Bachelors Degree Masters Degree Doctorate What is your employment status. Employed full time Employed part time Retired

Additional comments. address address city state or province zip or postal code Phone phone number

job title last name Your domain name web site URL has been registered with where registered at cost of domain registration fee. You have been registered as the Admin and or the Billing contact for your domain. The technical contact has been set to the tech contact at your hosting service host company. This domain registration fee fee allows you to use that domain name for years. After two years where registered will bill you domain renew fee per year. Your web site ISP will be host company. Your domain and account have been setup for the hosting of your web site. The one time setup fee of host setup fee and host monthly fee per month fee will be billed to directly to you by the hosting ISP. Please contact us if you have any questions. first name last name

job title company name phone number e mail address web site domain URL

company name Department Program Prioritized Essential Functions Essential functions are those organizational functions and activities that must be continued under any and all circumstances. Priority Essential Functions Key Personnel Required; List Alternates Systems Needed to Perform Function Current Location of System Alternate Location. If office is closed how can function be performed. How performed with limited staff. Leadership Leadership describes the order of succession to key positions within the organization. Orders should be of sufficient depth to ensure the organizations ability to manage and direct its essential functions and operations. Please list job titles in the table not employee names. Department Leadership Vital Files Records and Databases

This section addresses the departments vital files records and databases to include classified or sensitive data which are necessary to perform essential functions and activities and to reconstitute normal operations after the emergency ceases.

company name INVOICE address address city state or province zip or postal code Phone phone number DATE. current date INVOICE WorkOrder Bill To. company name

Attn. first name last name address address city state or province zip or postal code phone number For. What you are billing client for here DESCRIPTION HOURS RATE AMOUNT TOTAL Special. Make all checks payable to company name

Total due in days. Overdue accounts subject to service charge of 1% per month. THANK YOU FOR YOUR BUSINESS.

company name Statement of Work current date To. company contract with Re. proposal title Statement of Work ID#. contract reference number Budget. Not to exceed Insert Maximum Dollar Amount Purpose. Insert Short Description Contact. contract first name contract last name Fee Schedule. Insert Payment Terms Information Due Date date Administrative Requirements. 1. Insert Administrative Requirement. 2. Insert Administrative Requirement.

3. company contract with will develop this project under the terms and conditions of the Software Development Agreement SDA executed by the parties start date. 4. company name reserves the right to withhold all payments until all technical requirements have been demonstrated or met. 5. technical specification the Specification outlining the proposed solution will be provided by company contract with and accepted by company name and shall be considered deliverable to be met by company contract with under this agreement. 6. All contributing developers or contactors will provide detailed invoices and have signed non disclosure agreements prior to performing work on company name projects under this agreement. Product Requirements. Description Time Cash Allotted Insert Description Here hours hours hourly rate hr address address city state or province zip or postal code

Phone phone number

ADDENDUM. company name BILLABLE SERVICES. REFERENCE SHEET The purpose of this document is to explain several of the various services company name offers and to differentiate them from one another in order to understand how company name bills for its time and services. The following is list of the various services we offer and the billable rate per hour for each of the services. You may refer to these rates when calculating the job cost for each project. Service Type Billing Rate Hour Insert type of service offered hourly rate Insert type of service offered hourly rate Insert type of service offered hourly rate Insert type of service offered hourly rate Insert type of service offered hourly rate Fixed Rates and Costs

During the course of working with company name the following rates for expenses and fixed costs will apply. Fixed Cost Type Billing Rate Hour Insert description of cost type hourly rate Insert description of cost type hourly rate Insert description of cost type hourly rate Insert description of cost type hourly rate Insert description of cost type hourly rate Pass Through Costs and Expenses During the course of working with company name the following items may be billed to Company accounts on behalf of our clients. Pass Through Cost Type Billing Rate Hour Insert description of cost type hourly rate Insert description of cost type hourly rate Insert description of cost type hourly rate Insert description of cost type hourly rate Insert description of cost type hourly rate

MINUTES OF company name ANNUAL CORPORATE MEETING Date. current date The annual meeting of the shareholders of company name was held at Insert Time on current date at Insert Location The following attendees were present. NAME CONTACT INFO HOME ADDRESS Wk. Hm. Cell. Email. Wk. Hm. Cell. Email. Wk. Hm. Cell. Email. Wk. Hm. Cell. Email. Wk. Hm. Cell. Email. Wk. Hm. Cell. Email. Wk. Hm. Cell. Email. Insert Chairperson was appointed to be Chairman Chairwoman of the annual meeting. Insert Secretary was appointed to be Secretary of the annual meeting. In attendance were the following Board Members Directors. BOARD MEMBER NAME CONTACT INFO HOME ADDRESS

Wk. Hm. Cell. Email. Wk. Hm. Cell. Email. Wk. Hm. Cell. Email. The following acted as Board Members in Proxy. PROXY NAME CONTACT INFO HOME ADDRESS Wk. Hm. Cell. Email. Wk. Hm. Cell. Email. Wk. Hm. Cell. Email.

current date To. first name last name address city state or province zip or postal code Dear salutation last name;

At company name we value our customers. Wed like to take this opportunity to thank you for doing business with us. Insert any additional details youd like to include. Many companies attach coupons or special offers to Thank You letters. News of change in the organization such as change of name or address or new merchandise or services can also be included. Use formal address such as Dear Mr. Smith if you do not have personal relationship with the customer. If you are on first name basis use the familiar address such as Dear Susan. Best Wishes Signature of Sender first name last name job title

company name address city state or province zip or postal code

company name PURCHASE ORDER Purchase Order #. WorkOrder Order Date. current date Buyer. company name address address city state or province zip or postal code

phone number Seller. company name address address city state or province zip or postal code phone number Bill To. company name

address address city state or province zip or postal code phone number Ship To. company name address address city state or province zip or postal code

phone number FOB Payment Method. Ship Via. Terms of Sale Type. Description. Net days days Authorized by Buyer. Authorized by Seller. Order Details Qty Cost Amount Total. Special Notes.