LWO Printable Forms and Posters
Attention:
The Living Wage Rates, effective July 1, 2020 will increase to $15.00 per hour with health benefits of $1.25 per hour or $16.25 per hour if no health benefits are provided. For "Airport Employees" the Living Wage and health benefits hourly rate, effective July 1, 2020 will increase to $17.00 per hour and $5.67 per hour respectively, or $22.67 per hour if no health benefits are provided.
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For City Contractors
- LW 5 - Subcontractor's Declaration of Compliance
- LW 6 - Employee Information Form
- LW 6 - DWP - Employee Information Form
- LW 18 - Subcontractor Information Form
For Airport Contractors
- LAWA LW 5 - Subcontractor's Declaration of Compliance
- LAWA LW 6 - Employee Information Form
- LAWA LW 18 - Subcontractor Information Form
Exemption Forms for City/Airport Contractors
- LW 10 - Exemption Application
- LW 26 - Small Business Exemption Application (English)
- LW 26 - Small Business Exemption Application (Spanish)
- LW 28 - 501c3 Nonprofit Exemption Application
- LW 29 - Non-Coverage Determination Application
Health Benefit Exemption Form for City/Airport Employees
- LW 27- Online Benefits Waiver Application (English)
- LW 27- Online Benefits Waiver Application (Español)
- LW 27 - Benefits Waiver Paper Application (English)
- LW 27 - Benefits Waiver Paper Application (Español)
To be Posted by City/Airport Contractors once a Contract is Executed
- LW 11 - Notice to Employees re: LWO (English and Spanish)
- Notice to Employees re: Retaliation (English)
- Notice to Employees re: Retaliation (Spanish)
- Living Wage 11x17 Poster (City Contractors)
- Living Wage 11x17 Poster (Airport Contractors)
Complaint Forms for City/Airport Employees