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TELEWORK AGREEMENT This Agreement, effective the _____day of ______________, __________, by and between the Organization and _______________________________ ("Employee"), an employee of the Organization. The Organization agrees to permit Employee to work at home and Employee agrees to work at home under the following terms and conditions. Except for those additional conditions expressly imposed on Employee under this Agreement, the terms and conditions of Employee's employment with the Organization remain unchanged. The Employee remains fully responsible for compliance with the policies and procedures of the Organization and ____________________________. This document does not constitute a contract of employment, either express or implied. At the Organization, there is no fixed duration to the employment relationship. The telework arrangement does not abridge the at-will relationship of the employee and the Organization. Employees can terminate their employment whenever they wish and for whatever reason they might have, just as the Organization may terminate an Employee at any time for any lawful reason. Employee expressly acknowledges that he or she cannot rely on, or take any actions in reliance upon any particular duration of this agreement and/or of the permission to work at home. The employee certifies that he or she has read the following documents and agrees to follow the policies and procedures outlined in them: Organization Telework Policy Organization System-Wide Human Resource Policies _____________Telework Policy _____________Human Resource Policies Organization Confidentiality and Information Security Policy _____________ Confidentiality and Information Security Policy The location from which the Employee will telework is:________________________ _______________________________________________________________________ _______________________________________________________________________ The Employee's work area at the above location will be as follows: (describe the area in detail)____________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ In establishing the home work area, the Employee had determined that all common safety practices have been followed, and that this area provides a safe work environment for myself and others who may enter it. The Employee's telework schedule will be based on one of the three following options: Option 1Monday: Home Office_______________________ Company Office____________________ Work Hours_______________________ Tuesday: Home Office_______________________ Company Office____________________ Work Hours_______________________ Wednesday: Home Office_______________________ Company Office____________________ Work Hours_______________________ Thursday: Home Office_______________________ Company Office____________________ Work Hours_______________________ Friday: Home Office_______________________ Company Office____________________ Work Hours_______________________ Option 2 The employee agrees that he or she will devote ___________hours per day, __________days per week to Organization work assignments. Option 3 The employee agrees that his or her time will not be measured in hour per day or days per week, but rather on the achievement of certain output and/or productivity. Employee will achieve and productivity will be measured by __________________________________ __________________________________________during a _____________________ span of time. In all options, the Employee will provide his or her supervisor, on a bi-weekly basis, a timesheet certifying their hours of work, and if applicable, output and/or productivity for the preceding two weeks. All overtime must be approved in advance by the Supervisor. Timesheets are available from the Supervisor. Copies of the timesheet are acceptable. During scheduled telework times, I can be reached at_________________________. An alternative number where I may be reached is_____________________________. Work assignments upon which the employee will work and outputs which he or she will produce while teleworking are:_________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ The Organization will provide the following equipment for the telework arrangement: _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ The Employee will provide the following equipment for the telework arrangement: _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ Reimbursable expenses include:___________________________________________ _______________________________________________________________________ _______________________________________________________________________ If this telework arrangement has been approved by the supervisor for a predetermined length of time, the termination date of the Agreement shall be no later than:_______________________________________________________________ Other agreements or considerations are outlined as follows:____________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ If applicable, the employee agrees to obtain his or her telephone messages at least _______time(s) on each scheduled work day while teleworking. The employee also agrees that he or she will contact his or her Supervisor at east ________time(s) during each scheduled telework day. The employee agrees that he or she will report to the central work location, as needed and/or requested. Employee understands that the Telework Agreement is not an entitlement and may be revoked at any time by the Organization. This agreement may be terminated at any time by the supervisor by providing the employee notice in person or by telephone conversation, followed by written confirmation. _________________________________________ ___________________ Employee's Signature Date _________________________________________ ___________________ Supervisor's Signature Date Teleworking Policy |
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