Public Works and Government Services Canada
Symbol of the Government of Canada

Common menu bar links

Information on Incumbent Employees

NOTE: This form is to be used with respect to the Successor Employer provisions of the contract.

List below all your employees working at this workplace and give each employee, in box 7, a separate number. If more space is required for any of these items, attach additional pages and make reference to the employees' separate number and to the item number.

11. Period of employment

17. If hours of work vary from week to week, number of non-overtime hours for each week worked during the 13 weeks preceding the request for information.

18. Statement (check as applicable):
19. If applicable, check one of the boxes:

20. Information provided on this form is:

21. Name of authorized company representative:

Signature: _______________________________

  1. PWGSC
  2. Bidder(s)
  3. Successful Bidder
  4. Current Contrator