Associate Wage Notice
Associate Name: Maria Elena Mariscal Rocha Hire Date: 4/12/2021
EMPLOYER
Franchisor: Express Services, Inc., a corporation, dba Express Employment Professionals
Local Franchise: J. Noceda, Inc. , a corporation
(company name) (corporation, LLC, sole proprietorship, partnership etc.)
Local Address: 730 H Street, Suite 3, Chula Vista, CA, 91910
Local Telephone Number: (619) 452-2300
Franchisor Address and Telephone: 9701 Boardwalk Blvd., Oklahoma City, OK 73162, (800) 222-4057
WAGE INFORMATION
Pay Rate Range* for positions applied for: 14.00 Overtime Rate(s) of Pay: 21.00
Type(s) of Position(s): warehouse
Rate by (check boxes):
✔ Hour Shift Day Week Salary Piece Rate Commission
Other (provide specifics):
Does a written agreement exist providing the rate(s) of pay? (check box) Yes
✔
No
Allowances, if any, claimed as part of minimum wage (including meal or lodging allowances): NA
Regular Pay Day: Each Friday
Employment terms are both oral and written. Employment is at-will and may be terminated by the employer or the employee at any
time with or without cause or notice. The at-will nature of employment cannot be changed, except in a formal written agreement
signed by the employee and an authorized officer of the employer.
*Actual pay rate(s), hours, and location(s) worked will be indicated each week on your wage statement and will be determined based on the
type(s) of assignment(s) worked the previous week.
WORKERS’ COMPENSATION
Insurance Carrier’s Name: The Insurance Company of the State of Pennsylvania Policy No.: WC028234551
Address: 175 Water Street 18th Floor, New York, New York 10038 Telephone Number: 212-770-7000
Self-Insured (Labor Code 3700) and Certificate Number for Consent to Self-Insure: NA
PAID SICK LEAVE
Unless exempt, the associate identified on this notice is entitled to minimum requirements for paid sick leave under state law, which
provides that an employee:
a. May accrue paid sick leave and request and use up to 3 days or 24 hours of accrued paid sick leave per year
b. May not be terminated or retaliated against for using or requesting accrued paid sick leave
c. Has the right to file a complaint against an employer who retaliates or discriminates against an associate for
1. Requesting or using accrued sick days
2. Attempting to exercise the right to use accrued paid sick days
3. Filing a complaint or alleging a violation of Article 1.5 section 245 et seq. of the California Labor Code
4. Cooperating in an investigation or prosecution of an alleged violation of this Article or opposing any policy or practice or act
that is prohibited by Article 1.5 section 245 et seq. of the California Labor Code
The following applies to the employee identified on this notice: Accrues paid sick leave pursuant to the employer’s policy which
satisfies or exceeds the accrual, carryover, and use requirements of Labor Code §246.
ACKNOWLEDGEMENT OF RECEIPT
Maria Elena Mariscal Rocha
(PRINT NAME of Express representative) (PRINT NAME of Employee)
(SIGNATURE of Express representative) (SIGNATURE of Employee)
4/12/2021 4/12/2021
(Date provided to employee & signed by representative) (Date received by employee & signed by employee)
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.
©2020 Express Services, Inc. All rights reserved. AT198CA (03/20)
