Employee Name:
Job Title:
Budget Code:
Cell Phone No.
Start Date:
Monthly Amount
Reimbursed Quarterly:
(Select one below)
Tier 1: Low Use: $25.00
Tier 2: Medium Use: $50.00
Tier 3: High Use: $75.00
Bonneville County recognizes that an employee’s performance of certain job duties may need to
include the use of a personal cell phone to perform these duties. Elected Officials and
Department Heads shall determine which employees require the use of a personal cell phone and
at what level of use and reimbursement (Low, Medium, and High) each employee will receive,
on a quarterly basis, respective to the employee’s volume of use in the performance of their job
Employee Responsibilities
Purchase cellular phone equipment and service and assume responsibility for
vendor terms and conditions, to include paying all charges associated with the
cellular service and device.
Select a service provider, plan, and features that meet the requirements of the job
and the level of service that the reimbursement is intended to cover; and ensure the
carrier has service in the required usage areas.
Maintain an active service contract and working phone.
Promptly report any cell phone number changes.
Employee initial submission of personal cell phone bill.
Employee submission of a reimbursement claim to the County Clerk’s office.
Comply with all Federal and State data maintenance and protection laws.
Employee Certification
I have read, understand and agree to abide by the Employee Responsibilities listed above. I
also understand that Bonneville County reserves the right to amend the employee’s eligibility
for reimbursement or the rate of reimbursement at any time and by signing below, I certify
that I have read, understand, and agree to the Cell Phone Use & Reimbursement Agreement.
Employee Signature
Elected Official/Department Head Signature Date
Please return completed form to the Accounts Payable Clerk in Clerk’s Office.