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Public Psychological Services 10/29/2019
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Public Psychological Services 10/29/2019
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Last modified
10/17/2024 2:37:20 PM
Creation date
11/12/2019 10:33:51 AM
Metadata
Fields
Template:
Contracts
Contractor's Name
Public Psychological Services
Approval Date
10/29/2019
Department
Fire
Department Project Manager
Dave DeMarco
Subject / Project Title
Pre Employment Psychological Evaluation
Tracking Number
0002045
Total Compensation
$65,000.00
Contract Type
Agreement
Contract Subtype
Professional Services
Retention Period
6 Years Then Destroy
Document Relationships
LEPS/PSS PLLC dba Public Psychological Services 10/14/2024 Amendment 4
(Contract)
Path:
\Records\City Clerk\Contracts\6 Years Then Destroy\2025
Public Psychological Services 10/8/2021 Amendment 1
(Contract)
Path:
\Records\City Clerk\Contracts\6 Years Then Destroy\2022
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K13. During the last three years, have you ever committed, or been accused of committing, <br /> threats of physical harm, or stalking, directed at a spouse or romantic partner? <br /> a. No <br /> b. Yes, 1 time • <br /> c. Yes,2 times <br /> d. Yes, 3 or more times <br /> K14. Have you ever been named in any legal restraining order for behavior that threatened <br /> others in any way(such as actual physical harm; stalking; or threatening statements, <br /> letters, or phone calls)? <br /> a. No <br /> b. Yes, 1 time <br /> c. Yes, 2 times <br /> d. Yes, 3 or more times <br /> IF YOU ANSWERED"NO",SKIP TO QUESTION L1 IN THE NEXT SECTION. <br /> IF YOU ANSWERED"YES", CONTINUE WITH THE NEXT QUESTION(K15). <br /> K15. When were you last named in a legal restraining order--by a spouse or romantic <br /> partner, or by an employer or co-worker--for behavior that threatened others in <br /> any way(such as actual physical harm; stalking; or threatening statements, letters, <br /> or phone calls)? <br /> a. Within the last year <br /> b. Between one and four years ago <br /> c. Five or more years ago <br /> PARENTAL RESPONSIBILITIES <br /> Note: Your answers to the following questions may be verified by checks of records kept by police <br /> agencies, courts, and social service agencies, and by interviews with persons acquainted with <br /> you. If you deliberately give false or misleading answers, you may be disqualified. <br /> L1. Are there any children living with you(not counting brothers or sisters), whether or not they <br /> are your children, and whether or not you are responsible for them? <br /> a. No <br /> b. Yes <br /> L2. Of how many children are you the biological parent? <br /> a. None. I do not have any biological children <br /> b. 1 <br /> c. 2 <br /> d. 3-5 <br /> e. 6 or more <br /> L3. Are you currently delinquent with any child support obligations? <br /> a. No <br /> b. Yes <br /> PSS/LEPS PLLC 94 <br />
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