(303) 576-2230 info@kodiakbp.com

Employee Assistance

AUTOMATIC PAYROLL DEDUCTION

FILL OUT OUR FORM BELOW TO APPLY!

[[[["field14","equal_to","American Builders Supply"]],[["email_to",null,"brozinek@jonesheartz.com"]],"and"],[[["field14","equal_to","AO Door"]],[["email_to",null,"hr@jonesheartz.com"]],"and"],[[["field14","equal_to","Arizona Wholesale"]],[["email_to",null,"hr@jonesheartz.com"]],"and"],[[["field14","equal_to","Barnsco MI"]],[["email_to",null,"dreeves@barnsco.com"]],"and"],[[["field14","equal_to","Barnsco TX"]],[["email_to",null,"rsneed@barnsco.com"]],"and"],[[["field14","equal_to","Barton Materials"]],[["email_to",null,"bridilla@barton-supply.com"]],"and"],[[["field14","equal_to","Builders Alliance"]],[["email_to",null,"laura.henderson@fbs.us"]],"and"],[[["field14","equal_to","Builders Millwork Inc"]],[["email_to",null,"hsumner@buildersmillworkinc.com"]],"and"],[[["field14","equal_to","Christensen Lumber Inc."]],[["email_to",null,"jobs@christensenlumber.com"]],"and"],[[["field14","equal_to","Direct Lumber and Door of Colorado"]],[["email_to",null,"scarletl@directlumberanddoor.com"]],"and"],[[["field14","equal_to","Erect A Line"]],[["email_to",null,"ann@ealmfg.com"]],"and"],[[["field14","equal_to","Factory Builder Stores"]],[["email_to",null,"Clamb@factorybuilderstores.com"]],"and"],[[["field14","equal_to","Forest Tek\/Overseas Lumber"]],[["email_to",null,"lizzetter@keyslumber.com"]],"and"],[[["field14","equal_to","Freedom Materials"]],[["email_to",null,"hr@jonesheartz.com"]],"and"],[[["field14","equal_to","Frontier Building Supply"]],[["email_to",null,"laura.henderson@fbs.us"]],"and"],[[["field14","equal_to","Gulf & Basco"]],[["email_to",null,"CarolS@gulfbasco.com"]],"and"],[[["field14","equal_to","Jenkins Lumber & Hardware"]],[["email_to",null,"sharon@jenkinslumber.com"]],"and"],[[["field14","equal_to","Jones & Heartz"]],[["email_to",null,"hr@jonesheartz.com"]],"and"],[[["field14","equal_to","Kodiak Building Partners"]],[["email_to",null,"brozinek@jonesheartz.com"]],"and"],[[["field14","equal_to","Mandere Construction"]],[["email_to",null,"accounting@mandere.com"]],"and"],[[["field14","equal_to","Medallion Industries"]],[["email_to",null,"Roger.Ernst@MedallionIndustries.com"]],"and"],[[["field14","equal_to","New England Bldg Supply"]],[["email_to",null,"HR@nebldgsupply.com"]],"and"],[[["field14","equal_to","Northwest Building Components"]],[["email_to",null,"accounting@mandere.com"]],"and"],[[["field14","equal_to","Premier Building Supply"]],[["email_to",null,"hr@premierbuildingsupply.com"]],"and"],[[["field14","equal_to","Specialty Appliance"]],[["email_to",null,"cristina@buyfromsa.com"]],"and"],[[["field14","equal_to","Zarsky Lumber Co"]],[["email_to",null,"drobinson@zarsky.com"]],"and"],[[["field14","equal_to","Jenkins Drywall & Insulation"]],[["email_to",null,"hr@jonesheartz.com"]],"and"],[[["field14","equal_to","Freedom Acoustics"]],[["email_to",null,"hr@jonesheartz.com"]],"and"]]
1 Step 1
Authorization for Automatic Payroll Deduction for Employee Assistance Fund
25% of all contributions will be matched by Kodiak

I give authorization to Kodiak Building Partners, its respective subsidiaries, and its affiliates, to deduct contributions to the Employee Assistance Fund, which is a part of the Kodiak Building Partners Foundation.

I understand that this is a voluntary after-tax deduction that can be taken as a deduction when filing my individual tax return and that my deduction will be sent directly to the Employee Assistance Fund. This deduction can be stopped at any time by checking Cancel Payroll Deduction and submitting this form.

At no time will a verbal authorization be accepted either to change or stop the amount of the voluntary deduction. If changes need to be made to the amount or duration of the deduction, the employee must complete and sign a new form authorizing the change or canceling this approval.

I authorize one of the following deductions:
Recurring
Amount
One-Time
Amount
Cancel
Full Name
Title
Last 4 Digitis of SS#
Signature
Date
date_range
SMALL ACTIONS X LOTS OF PEOPLE = HELPING OTHERS
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