New Hire Packet - Infiniti HR

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Infiniti HR 3905 National Dr. Ste. 400 Burtonsville, MD 20866 301-841-6380 Toll Free 866-552-6360 Fax: 240-722-0090 NEW HIRE PACKET (For California Employee Use Only) vJan2019

Welcome to INFINITI HR. Your Employer has contracted with INFINITI HR to provide you with some of the most comprehensive and flexible Payroll, Human Resource, Employee Benefits and Risk Management services. Our goal is to make your employer’s job easier and to provide you with extensive employee benefit options. At INFINITI HR we have several different service models, so you may hear terms like Professional Employer Organization (PEO) or Administrative Service Organization (ASO). The PEO model establishes a co- ‐employment relationship with your present employer that divides the duties of the employer into “On- ‐site Employer”, and “Professional Employer.” This relationship allows you to become part of a larger group so that you can access additional resources and benefits, while providing administrative relief to your current employer. The ASO model allows INFINITI HR to become your off-site Human Resources Department under a more traditional service provider relationship. We hope that you will be as excited as we are that your current employer has decided to partner with INFINITI HR. If you have any questions you can always call us at our toll free number listed below. 1.866.552.6360 INSTRUCTIONS: Page 2 Employee Enrollment Check List Complete Employee Data Form 3 Complete EEO-1 Voluntary Self-ldentification Form: Read and then complete requested information. 4 5 Direct Deposit Authorization: Complete if you want your paycheck deposited directly into your account(s). Attach voided check(s) for checking account(s). Contact your bank for the necessary form for direct deposit to a savings account. Employment Policies: Read and keep for your records. 6 Acknowledgment Form: Sign and return to INFINITI HR. 8 Form I-9: Complete and sign Employment Eligibility Verification form. Employers must complete and 9 sign Form I-9 Section 2. For a full copy of the I-9, containing all instructions, please go to http:// or call 1-800-375-5283. 12 Form W-4: Employee’s Withholding Allowance Certificate. Complete and sign. 16 Form 8850 and Work Opportunity Tax Credit Questionnaire (WOTC): Pre-Screening Notice and Certification Request. Complete, sign and return the original to INFINITI HR. 24 General Notice of COBRA Continuing Coverage: Complete and sign (if applicable). 34 Workers' Compensation Notice: Complete and sign (if applicable). 3905 National Drive, Suite 400, Burtonsville, MD 20866 1 I 301-841-6380 I 240-722-0090 (F)

Employee Enrollment Check List Enclosed is the documentation required to transition your personnel file to INFINITI HR and process your paycheck. ! Employment Application/Employee Data Form ! EEO-1 Voluntary Self-Identification Form ! Direct Deposit Authorization ! Employment Policies ! Acknowledgment Form ! Form I-9, Employment Eligibility Verification ! Form W-4, Employee’s Federal Withholding Allowance Certificate ! Applicable State Tax Withholding Form. Your Federal withholding allowance will be used if a state withholding form is not returned. ADDENDUM: ! Time of Hire ! DWC Form 9783: Personal Physician Designation Form ! DWC Form 9783.1: Personal Chiropractor/Acupuncture Designation Form ! General Notice of COBRA Continuation Coverage Rights (California Employees) ! Discrimination is Against the Law ! Paid Family Leave ! Sexual Harrassment ! Workers' Compensation Notice ! Disability Insurance Provision This completed packet must be received by INFINITI HR no later than 2 days after the first day worked to ensure the employee will receive a payroll check on the next regularly scheduled payday. 2 2

Employee Data Form Social Security Number: Pay Type: " Hourly " Salary " Other Employee Name: Last First Date of Birth: Middle Email: Address: House/Street ( ) Home Telephone Number City/State/Zip ( ) Cell Telephone Number Emergency Contact Name: Telephone: Address: Relationship to Employee: Finally, I certify all information provided by me is true and correct and understand that any intentional falsification of information is grounds for termination. Signature of Applicant Date TO BE COMPLETED BY THE CLIENT Client Name: Hire Date: Job Title: Pay Rate: per EMPLOYEE TYPE: Part-Time Full-Time Hourly Commission Only Salary 3 3

EEO-1 Voluntary Self-Identification Form It is the policy of INFINITI HR to provide equal employment and advancement opportunities to all individuals. The following information is used to assist INFINITI HR in maintaining the statistics for the annual EEO-1 Report which we are required to submit to the Federal Government each year. Completion of this form is voluntary and in no way affects any decision regarding your employment. This form is confidential and will be maintained separately from your application. Name: Date: Position Title: GENDER (Please check one of the options below) MALE RACE/ETHNICITY FEMALE (Please check one of descriptions below corresponding to the ethnic group with which you identify) HISPANIC OR LATINO: a person of Cuban, Mexican, Chicano, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race. WHITE: a person having origins in any of the original peoples of Europe, the Middle East, or North Africa. BLACK OR AFRICAN AMERICAN: a person having origins in any of the black racial groups of Africa. ASIAN: a person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam. NATIVE HAWAIIAN OR OTHER PACIFIC ISLANDER: a person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands. AMERICAN INDIAN OR ALASKA NATIVE: a person having origins in any of the original peoples of North and South America (including Central America), and who maintains tribal affiliation or community attachment. TWO OR MORE RACES: a person who primarily identifies with two or more of the above race/ethnicity categories. I DO NOT WISH TO DISCLOSE INFINITI HR - CONFIDENTIALL 4

Direct Deposit Form Company Name: Employee Name: I authorize INFINITI HR, Cachet Banq and all financial institution(s) involved in each transaction to deposit my pay automatically to the indicated account(s) and to make adjusting entries including the removal of funds if the employer does not make them available, in which case, I waive any rights I may have to return debit entries to my account and personally guaranty the return of the funds in question. BANK / CREDIT UNION STATE Routing Number TYPE AMOUNT (Circle One) ACCOUNT NUMBER o Checking o Saving o Checking o Saving o Checking o Saving Please Check One: New or Additional Direct Deposit Change the Bank or Account Number on an Existing Direct Deposit Account Number to Be Replaced: Change the amount of an existing Direct Deposit Amount was: Amount Changed to: Other (Please Explain): Please Attach a Voided Check for the Direct Deposit Bank Account as Verification for Each Request. Deposits are normally available two (2) banking days after payroll is processed. It is my responsibility to verify deposits on a per pay period basis before writing checks against these funds. This Authorization can take up to three (3) pay periods to activate. I understand that ne ithe r Infiniti HR or Cache t Banq is responsible for bank errors or bank fees. Direct Deposit Financial services are provided in accordance with INFINITI HR’s Direct Deposit Agre e me nt, Cachet Banq’s Power of Attorney/Guaranty/Terms and Conditions and the limitations and restrictions of the National Automated Clearing House Association. I may cancel these Direct Deposit(s) at any time. Signature Date 5 5

Employment Policies DRUG AND ALCOHOL FREE WORKPLACE POLICY INFINITI HR and our clie nts strive to provide a safe work e nvironme nt and e ncourage pe rsonal he alth. In keeping with this policy, the company considers the abuse of drugs or alcohol on the job to be an unsafe and a counter productive work practice . It is, the re fore , company policy that an e mploye e de te cte d to have alcohol or ille gal drugs in his/her system, in possession of, using, selling, trading, or offering for sale illegal drugs or alcohol during working hours, will be subject to disciplinary action including discharge. (Company sponsored activities which may include the service of alcoholic beverages are not included in this provision. Discretion should be exercised by the employee to avoid overindulging in the consumption of alcohol.) Substance Abuse includes possession, use, purchase, or sale of drugs or alcohol on company premises (including the parking lots). Employees will be required to submit to drug and/or alcohol testing at a laboratory chosen by the company for the following reasons: 1. Observed alcohol or drug abuse during work hours on company premises. 2. Apparent physical state of impairment. 3. Incoherent mental state. 4. Accidents or other actions that provide reasonable cause to believe the employee may be under the influence. 5. As required by any government programs such as the US Department of Transportation. In addition to testing for the purposes above, Infiniti HR and its clients reserve the right to randomly test employees. Refusal to such testing will subject an employee to disciplinary action up to and including termination of employment. ANTI-HARRASSMENT INFINITI HR and its client companies have zero tolerance for and therefore prohibit all forms of discriminatory practices, including unlawful harassment of employees by managers, fellow employees, and employees of contractors, visitors or any other third parties on Infiniti HR or client company premises. This prohibition includes but is not limited to any demeaning, insulting, embarrassing or intimidating behavior directed at any employee because of their race, color, religion, sex, age, sexual orientation, national origin, genetic information, disability or any other protected characteristic as established by law. Sexual harassment constitutes discrimination and is illegal under Federal, state and local laws. For the purposes of this policy, sexual harassment is defined, as in the Equal Employment Opportunity Commission Guidelines, as unwelcome sexual advances, requests for sexual favors and other verbal or physical conduct of a sexual nature when, for example: (i) submission to such conduct is made either explicitly or implicitly a term or condition of an individual's employment; (ii) submission to or rejection of such conduct by an individual is used as the basis for employment decisions affecting such individual; or (iii) such conduct has the purpose or effect of unreasonably interfering with an individual's work performance or creating an intimidating, hostile or offensive working environment. Sexual harassment can take two distinct forms: quid pro quo and hostile work environment. One, quid pro quo harassment, occurs when submission to sexual conduct is made a condition of employment or employment benefits. Two, hostile work environment occurs when sexual or other discriminating and unlawful conduct unreasonably interferes with an employee’s work performance or creates an intimidating, abusive, or offensive work environmen Harassing conduct that is PROHIBITED includes, but is not limited to epithets, slurs or negative stereotyping, threatening, intimidating or hostile acts, denigrating jokes and display or circulation in the workplace of written or graphic material that denigrates or shows hostility or aversion toward an individual or group (including through e-mail). Incidents of alleged discrimination or harassment will be taken seriously by the client Company. INFINITI HR offers an HR Hotline for reporting and will assist with or guide a client company on how to investigate and proceed with corrective action if necessary. Retaliation Is Prohibited INFINITI HR and its client companies prohibit retaliation against any individual who reports discrimination or harassment or participates in an investigation of such reports. Retaliation against an individual for reporting harassment or discrimination or for participating in an investigation of a claim of harassment or discrimination is a serious violation of this policy and, like harassment or discrimination itself, will be subject to corrective action. 6 6

REPORTING PROCEDURE Any individual who believes they have witnessed or been subject to discrimination, including unlawful harassment, regardless of the offender's identity or position, must report the circumstances as soon as possible to any one of the following: immediate Supervisor or Manager, authorized internal or Infiniti HR assigned Human Resources Administrator, Officer of the Company or similar high level Executive, or any person designated in the Employee Handbook as a Contact Person. Upon completion of any investigation, Infiniti HR or the client company will take appropriate action. ADA and ADAA POLICY INFINITI HR and client companies are committed to complying with all applicable provisions of the Americans with Disabilities Act (ADA) and the Americans with Disabilities Act Amendments Act (ADAAA). It is the policy of INFINITI HR and Client Company to not discriminate against any qualified employee with regard to any terms or conditions of employment because of the individual’s disability or perceived disability so long as the qualified individual can perform the essential functions of the job. Client Company will provide reasonable accommodations to a qualified individual with a disability so that they can perform the essential functions of a job unless doing creates an undue hardship to the client company. INFINITI HR and Client Company will follow any state or local law that provides individuals with disabilities greater protection than the ADA & ADAAA. This policy is neither exhaustive nor exclusive. INFINITI HR and Client Company is committed to taking all other actions necessary to ensure equal employment opportunity for persons with disabilities in accordance with the ADA, ADAAA and all other applicable federal, state, and local laws. REQUESTING AN ACCOMODATION If an employee feels that are in need of an accommodations, they should contact their immediate Supervisor or Manager, authorized internal or INFINITI HR assigned Human Resources Administrator, Officer of the Company or similar high level Executive, or any person designated in the Employee Handbook as a Contact Person. PAYROLL DEDUCTIONS The following mandatory deductions will be made from every employee’s gross wages: federal income tax, Social Security FICA tax, and applicable city and state taxes. Every employee must fill out and sign a federal withholding allowance certificate, IRS Form W- ‐4, on or before his or her first day on the job. This form must be completed in accordance with federal regulations. The employee may fill out a new W- ‐4 at any time when his or her circumstances change. Employees who paid no federal income tax for the preceding year and who expect to pay no income tax for the current year may fill out an Exemption from Withholding Certificate, IRS Form W- ‐4E. Employees are expected to comply with the instructions on Form W- ‐4. Questions regarding the propriety of claimed deductions may be referred to the IRS in certain circumstances. Other optional deductions include the portion of group health insurance not paid by the company, which is deducted from each payroll check. Other voluntary contributions, such as credit union and pension plan, are also deducted each pay period. Any other deductions from pay require your voluntary, written and specific authorization to do so. 7 7

ACKNOWLEDGEMENT I acknowledge that I have received my copy of the INFINITI HR Employment Policies, contained within its New Hire Packet used by worksite employer. I have read and understand these policies and acknowledge that they outline practices, expectations and guidelines set by INFINITI HR , agreed to by my worksite employer, that I am required to follow. I further understand that violations of the policies contained within, including but not limited to the anti-harassment policy, could result in corrective action, up to and including termination. Since the information in these policies is subject to change as situations warrant, it is understood that changes in future new hire packets or policies within similar HR documents, such as my worksite employer’s Employee Handbook, may supersede, revise, or eliminate one or more of the policies. These changes will be identified or communicated to me by my supervisor/manager or through similarly responsible worksite representatives. I accept responsibility for keeping informed of these changes. I further acknowledge my understanding that my employment with INFINITI HR is considered at will and may be terminated at any time with or without cause. Only official executed, legally binding contracts of employment supersede employment at will Employee’s Signature: Date: Name (Please Print): 8 8

USCIS Form I-9 Employment Eligibility Verification Department of Homeland Security U.S. Citizenship and Immigration Services OMB No. 1615-0047 Expires 08/31/2019 START HERE: Read instructions carefully before completing this form. The instructions must be available, either in paper or electronically, during completion of this form. Employers are liable for errors in the completion of this form. ANTI-DISCRIMINATION NOTICE: It is illegal to discriminate against work-authorized individuals. Employers CANNOT specify which document(s) an employee may present to establish employment authorization and identity. The refusal to hire or continue to employ an individual because the documentation presented has a future expiration date may also constitute illegal discrimination. Section 1. Employee Information and Attestation (Employees must complete and sign Section 1 of Form I-9 no later than the first day of employment, but not before accepting a job offer.) Last Name (Family Name) Apt. Number Address (Street Number and Name) Date of Birth (mm/dd/yyyy) Middle Initial First Name (Given Name) U.S. Social Security Number Other Last Names Used (if any) State City or Town ZIP Code Employee's Telephone Number Employee's E-mail Address I am aware that federal law provides for imprisonment and/or fines for false statements or use of false documents in connection with the completion of this form. I attest, under penalty of perjury, that I am (check one of the following boxes): 1. A citizen of the United States 2. A noncitizen national of the United States (See instructions) 3. A lawful permanent resident (Alien Registration Number/USCIS Number): 4. An alien authorized to work until (expiration date, if applicable, mm/dd/yyyy): Some aliens may write "N/A" in the expiration date field. (See instructions) QR Code - Section 1 Do Not Write In This Space Aliens authorized to work must provide only one of the following document numbers to complete Form I-9: An Alien Registration Number/USCIS Number OR Form I-94 Admission Number OR Foreign Passport Number. 1. Alien Registration Number/USCIS Number: OR 2. Form I-94 Admission Number: OR 3. Foreign Passport Number: Country of Issuance: Signature of Employee Today's Date (mm/dd/yyyy) Preparer and/or Translator Certification (check one): I did not use a preparer or translator. A preparer(s) and/or translator(s) assisted the employee in completing Section 1. (Fields below must be completed and signed when preparers and/or translators assist an employee in completing Section 1.) I attest, under penalty of perjury, that I have assisted in the completion of Section 1 of this form and that to the best of my knowledge the information is true and correct. Today's Date (mm/dd/yyyy) Signature of Preparer or Translator Last Name (Family Name) Address (Street Number and Name) First Name (Given Name) City or Town State ZIP Code Employer Completes Next Page Form I-9 07/17/17 N Page 1 of 3

USCIS Form I-9 Employment Eligibility Verification Department of Homeland Security U.S. Citizenship and Immigration Services OMB No. 1615-0047 Expires 08/31/2019 Section 2. Employer or Authorized Representative Review and Verification (Employers or their authorized representative must complete and sign Section 2 within 3 business days of the employee's first day of employment. You must physically examine one document from List A OR a combination of one document from List B and one document from List C as listed on the "Lists of Acceptable Documents.") Employee Info from Section 1 Last Name (Family Name) List A First Name (Given Name) OR List B M.I. AND List C Identity Identity and Employment Authorization Citizenship/Immigration Status Employment Authorization Document Title Document Title Document Title Issuing Authority Issuing Authority Issuing Authority Document Number Document Number Document Number Expiration Date (if any)(mm/dd/yyyy) Expiration Date (if any)(mm/dd/yyyy) Expiration Date (if any)(mm/dd/yyyy) Document Title QR Code - Sections 2 & 3 Do Not Write In This Space Additional Information Issuing Authority Document Number Expiration Date (if any)(mm/dd/yyyy) Document Title Issuing Authority Document Number Expiration Date (if any)(mm/dd/yyyy) Certification: I attest, under penalty of perjury, that (1) I have examined the document(s) presented by the above-named employee, (2) the above-listed document(s) appear to be genuine and to relate to the employee named, and (3) to the best of my knowledge the employee is authorized to work in the United States. The employee's first day of employment (mm/dd/yyyy): Signature of Employer or Authorized Representative Last Name of Employer or Authorized Representative (See instructions for exemptions) Today's Date (mm/dd/yyyy) Title of Employer or Authorized Representative First Name of Employer or Authorized Representative Employer's Business or Organization Address (Street Number and Name) City or Town Employer's Business or Organization Name State ZIP Code Section 3. Reverification and Rehires (To be completed and signed by employer or authorized representative.) A. New Name (if applicable) Last Name (Family Name) B. Date of Rehire (if applicable) First Name (Given Name) Middle Initial Date (mm/dd/yyyy) C. If the employee's previous grant of employment authorization has expired, provide the information for the document or receipt that establishes continuing employment authorization in the space provided below. Document Title Document Number Expiration Date (if any) (mm/dd/yyyy) I attest, under penalty of perjury, that to the best of my knowledge, this employee is authorized to work in the United States, and if the employee presented document(s), the document(s) I have examined appear to be genuine and to relate to the individual. Signature of Employer or Authorized Representative Form I-9 07/17/17 N Today's Date (mm/dd/yyyy) Name of Employer or Authorized Representative Page 2 of 3

LISTS OF ACCEPTABLE DOCUMENTS All documents must be UNEXPIRED Employees may present one selection from List A or a combination of one selection from List B and one selection from List C. LIST A Documents that Establish Both Identity and Employment Authorization 1. U.S. Passport or U.S. Passport Card 2. Permanent Resident Card or Alien Registration Receipt Card (Form I-551) 3. Foreign passport that contains a temporary I-551 stamp or temporary I-551 printed notation on a machinereadable immigrant visa 4. Employment Authorization Document that contains a photograph (Form I-766) 5. For a nonimmigrant alien authorized to work for a specific employer because of his or her status: a. Foreign passport; and b. Form I-94 or Form I-94A that has the following: (1) The same name as the passport; and (2) An endorsement of the alien's nonimmigrant status as long as that period of endorsement has not yet expired and the proposed employment is not in conflict with any restrictions or limitations identified on the form. 6. Passport from the Federated States of Micronesia (FSM) or the Republic of the Marshall Islands (RMI) with Form I-94 or Form I-94A indicating nonimmigrant admission under the Compact of Free Association Between the United States and the FSM or RMI LIST B LIST C Documents that Establish Employment Authorization Documents that Establish Identity OR AND 1. Driver's license or ID card issued by a State or outlying possession of the United States provided it contains a photograph or information such as name, date of birth, gender, height, eye color, and address 2. ID card issued by federal, state or local government agencies or entities, provided it contains a photograph or information such as name, date of birth, gender, height, eye color, and address 3. School ID card with a photograph 4. Voter's registration card 5. U.S. Military card or draft record 6. Military dependent's ID card 7. U.S. Coast Guard Merchant Mariner Card 8. Native American tribal document 9. Driver's license issued by a Canadian government authority For persons under age 18 who are unable to present a document listed above: 1. A Social Security Account Number card, unless the card includes one of the following restrictions: (1) NOT VALID FOR EMPLOYMENT (2) VALID FOR WORK ONLY WITH INS AUTHORIZATION (3) VALID FOR WORK ONLY WITH DHS AUTHORIZATION 2. Certification of report of birth issued by the Department of State (Forms DS-1350, FS-545, FS-240) 3. Original or certified copy of birth certificate issued by a State, county, municipal authority, or territory of the United States bearing an official seal 4. Native American tribal document 5. U.S. Citizen ID Card (Form I-197) 6. Identification Card for Use of Resident Citizen in the United States (Form I-179) 7. Employment authorization document issued by the Department of Homeland Security 10. School record or report card 11. Clinic, doctor, or hospital record 12. Day-care or nursery school record Examples of many of these documents appear in Part 13 of the Handbook for Employers (M-274). Refer to the instructions for more information about acceptable receipts. Form I-9 07/17/17 N Page 3 of 3

Form W-4 (2019) Future developments. For the latest information about any future developments related to Form W-4, such as legislation enacted after it was published, go to Purpose. Complete Form W-4 so that your employer can withhold the correct federal income tax from your pay. Consider completing a new Form W-4 each year and when your personal or financial situation changes. Exemption from withholding. You may claim exemption from withholding for 2019 if both of the following apply. For 2018 you had a right to a refund of all federal income tax withheld because you had no tax liability, and For 2019 you expect a refund of all federal income tax withheld because you expect to have no tax liability. If you’re exempt, complete only lines 1, 2, 3, 4, and 7 and sign the form to validate it. Your exemption for 2019 expires February 17, 2020. See Pub. 505, Tax Withholding and Estimated Tax, to learn more about whether you qualify for exemption from withholding. General Instructions If you aren’t exempt, follow the rest of these instructions to determine the number of withholding allowances you should claim for withholding for 2019 and any additional amount of tax to have withheld. For regular wages, withholding must be based on allowances you claimed and may not be a flat amount or percentage of wages. You can also use the calculator at to determine your tax withholding more accurately. Consider using this calculator if you have a more complicated tax situation, such as if you have a working spouse, more than one job, or a large amount of nonwage income not subject to withholding outside of your job. After your Form W-4 takes effect, you can also use this calculator to see how the amount of tax you’re having withheld compares to your projected total tax for 2019. If you use the calculator, you don’t need to complete any of the worksheets for Form W-4. Note that if you have too much tax withheld, you will receive a refund when you file your tax return. If you have too little tax withheld, you will owe tax when you file your tax return, and you might owe a penalty. Filers with multiple jobs or working spouses. If you have more than one job at a time, or if you’re married filing jointly and your spouse is also working, read all of the instructions including the instructions for the Two-Earners/Multiple Jobs Worksheet before beginning. Nonwage income. If you have a large amount of nonwage income not subject to withholding, such as interest or dividends, consider making estimated tax payments using Form 1040-ES, Estimated Tax for Individuals. Otherwise, you might owe additional tax. Or, you can use the Deductions, Adjustments, and Additional Income Worksheet on page 3 or the calculator at to make sure you have enough tax withheld from your paycheck. If you have pension or annuity income, see Pub. 505 or use the calculator at to find out if you should adjust your withholding on Form W-4 or W-4P. Nonresident alien. If you’re a nonresident alien, see Notice 1392, Supplemental Form W-4 Instructions for Nonresident Aliens, before completing this form. Specific Instructions Personal Allowances Worksheet Complete this worksheet on page 3 first to determine the number of withholding allowances to claim. Line C. Head of household please note: Gener

Infiniti HR 3905 National Dr. Ste. 400 Burtonsville, MD 20866 301-841-6380 Toll Free 866-552-6360 Fax: 240-722-0090 (For California Employee Use Only) . (California Employees)! Discrimination is Against the Law! Paid Family Leave! Sexual Harrassment! Workers' Compensation Notice! Disability Insurance Provision. 3 3

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