1. NOTICE TO EMPLOYEE
Labor Code section 2810.5
Effective January 1, 2012, California Labor Code section 2810.5(a) requires that the following information be
provided to each employee at the time of hire in the language the employer normally uses to communicate
employment-related information. Exceptions to this requirement are indicated on the next page.This notice is
available in other languages at www.dir.ca.gov/DLSE.
EMPLOYEE
Name: Danielle Sandifer
Hire Date: March 17, 2014
EMPLOYER
Robert Half, a staffing agency (e.g., temp agency or PEO), is a corporation which also does business as
Accountemps, Benchmark Staffing Inc., OfficeTeam, Robert Half Financial Services Group, Robert Half
Legal, Robert Half Management Resources, Robert Half Technology, and The Creative Group. Robert Half
will be your sole employer; you will have no co-employer.
Main Office: 2884 Sand Hill Road, Menlo Park, CA 94025
Mailing Address: 2884 Sand Hill Road, Menlo Park, CA 94025
Telephone Number: 888-744-9202
WAGE INFORMATION
You will be paid on an hourly basis. Your hourly rate of pay on this assignment with Brand Scaffold will be
$17.00, your overtime rate will be $25.50, and your double time rate will be $34.00.
Main Office: 222 Gateway Road West, Napa, CA 94558
Work Site Address: 222 Gateway Road West, Napa, CA 94558
Phone Number: (707) 558-1800
Your hourly rate of pay may vary from assignment to assignment, and as required by federal and state law.
We will provide notice of any change in your hourly rate on the pay stub (i.e., itemized wage statement) that
follows the date that your change goes into effect. Your overtime rates will always be time and one-half and
double time your hourly rate and will be shown on your pay stub when you work overtime or double time.
Your employment agreement is written. Your employment is at will. We use written agreements and other
documents to convey many important employee rights and responsibilities.
You will be paid via direct deposit or U.S. mail no later than Friday following the week worked. Please refer
to the Welcome Brochure regarding our on-line time reporting system. You must submit your work hours in a
timely manner.

2. WORKERS’ COMPENSATION
Insurance Carrier
The Insurance Company of the State of Pennsylvania
175 Water Street, 18th Floor, New York, NY 10038
Telephone Number: 212-770-7000
Policy Number: WC 015883630
Insurance Administrator
Gallagher Bassett Services, Inc.
P.O. Box 4040, Sacramento, CA 95812-4040
Telephone Number: 866-481-0962
PLEASE REPLY TO THIS EMAIL TO ACKNOWLEDGE ITS RECEIPT OR,
IF RECEIVED BY U.S. MAIL, PLEASE SIGN AND DATE BELOW TO ACKNOWLEDGE
RECEIPT, AND RETURN TO YOUR LOCAL BRANCH OFFICE.
Labor Code section 2810.5(b) requires that the employer notify you in writing of any changes to the
information set forth in this Notice within seven calendar days after the time of the changes, unless one of the
following applies: (a) All changes are reflected on a timely wage statement furnished in accordance with Labor
Code section 226; (b) Notice of all changes is provided in another writing required by law within seven days of
the changes.
This Notice is NOT required if (a) you are directly employed by the state or any political subdivision thereof,
(b) you are an employee who is exempt from the payment of overtime wages by statute or wage order, or (c)
you are covered by a collective bargaining agreement that expressly provides for wages, hours of work and
working conditions, and provides for premium wage rates for all overtime worked.
The full text of Labor Code section 2810.5 may be found at www.leginfo.ca.gov/calaw.html. Check "Labor
Code" and search for "2810.5" in quotes.
The employee’s signature on this notice merely constitutes acknowledgement of receipt. In accordance with
an employer’s general record keeping requirements under the law, it is the employers obligation to ensure that
the employment and wage-related information provided on this notice is accurate and complete. Furthermore,
the employee’s signature acknowledging receipt of this notice does not constitute a voluntary written
agreement as required under the law between the employer and employee in order to credit any meals or
lodging against the minimum wage. Any such voluntary written agreement must be evidenced by a separate
document.
Employee Signature: _________________________________________________________________
Date: ______________________________________________________________________________
People Number: 1001695674, JO#: 00590-108883