COVID-19 Vaccination Policy for Contractors

York Region has implemented a COVID-19 Vaccination Policy for Contractors. This form must be completed and submitted to York Region by January 10, 2022.

Business Information

This form must be completed by a person with signing authority.

First Name

Last Name

Name of Organization

Job Title

This business is incorporated?

Yes

There is only one employee at the business?

Yes

The information on this form is collected under the authority of Section 25(2)(h) of Occupational Health and Safety Act and is collected, used, and disclosed in accordance with the Municipal Freedom of Information and Protection of Privacy Act. Questions regarding the collection, use, and disclosure of the information may be directed to your Branch or Division Contract Administrator or Project Manager.