COVID-19: EMPLOYEE TELEWORK AGREEMENT
(Departments: Retain a Copy)
Employee Name:
Phone (home/work):
Department:
Position Title:
Telework Start Date:
Telework End Date:
A temporary telework arrangement (“alternative work arrangement”) is hereby established between Tompkins
County and the above-mentioned employee. The purpose of this agreement is to clarify the terms and conditions
under which the employee will be allowed to participate in this work arrangement as described below.
1. Telework Location (address): ____________________________________________________________
2. Telework Contact Number(s): ____________________________
3. Telework Schedule:
Number of days: Per week ______________ Per month ______________
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Hours
Meal
Period*
Location**
* Must include a ½ hour unpaid meal period for any employee who works a shift of more than 6 hours per
NYS Department of Labor.
**For location, please use “T” for Telework Location and “D” for Designated County Worksite.
4. Assigned tasks/projects (include deadline, if applicable): __________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
5. Expectations and Performance Requirements: __________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
6. Work Performance Evaluation Schedule: ______________________________________________________
_____________________________________________________________________________________________
7. County Equipment & Serial # Record (if applicable): ____________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
It is expressly understood and agreed that this work arrangement does not create or define the terms of any contract
of employment, whether expressed or implied.
Terms of Arrangement: This telework arrangement shall be in effect for a maximum of four (4) weeks.
Continuation and renewal of said agreement will be evaluated at the end of the stated agreement period.
This agreement is subject to the employee satisfying the following conditions on a continuing basis:
Employee obligations, duties, responsibilities, and terms and conditions of employment are unchanged.
The employee shall perform all job duties at a satisfactory performance level or above.
The employee must comply with all County and departmental policies and procedures while working a
telework schedule.
The employee will maintain confidentiality as required by the County, Federal, State, and Local laws.
The employee will maintain the agreed-upon work schedule and be accessible via telephone and email
during telework hours.
The employee will participate in routine work performance evaluations as required.
The employees shall not conduct any unauthorized external (non-County) work during their telework
schedule.
The employee will maintain an ergonomically appropriate home office environment.
Any non-compliance with these terms by the employee may result in modification or termination of the
telework arrangement at any time.
Hours of Work and Compensation: The employee agrees to be responsible for maintaining the agreed upon hours
of work and is required to keep a detailed record of hours worked (as well as verification as applicable), and to enter
hours worked into the County timekeeping system as instructed. Employee pay rates and accrual of leave time
benefits remain unchanged and in accordance with the terms of this agreement the employee will be compensated
for all hours during which work is performed. Employees must get advance authorization for any hours worked
outside of or beyond their normal work schedule. Employees are required to take rest and meal breaks per NYS
Labor Laws and applicable collective bargaining agreements. The County will not reimburse the employee for the
cost of any off-site related expenses and any personal tax implications related to the telework location shall be the
employee’s responsibility.
Liability: Workers Compensation benefits will apply only to injuries arising out of and in the course of employment
as defined by New York State Workers’ Compensation Law. The employee must report any such work-related
injuries to their supervisor and County Risk Manager immediately. Tompkins County is not responsible for any loss,
damage, destruction to property or for any injury or loss to third persons at the approved telework site.
Confidentiality and Non-Disclosure: During the course of their employment with Tompkins County, the
aforementioned employee has gained knowledge of and/or access to confidential and proprietary information. By the
execution of this agreement, the employee understands that they are expressly prohibited from disclosing to any
unauthorized person, company, or other entity any such information, and is prohibited from using any such
information for personal gain or profit. The employee understands that confidential information, systems, or data
and all items made or compiled by the employee or made available to the employee during any period of
employment shall be and remain exclusive property of the County. Upon separation of employment with the
County, the employee shall immediately return any such property to the County and no copies thereof may be kept
by the employee.
Agreement Acknowledgment: I have read and understand this agreement and all its provisions. By signing below,
I agree to be bound by all terms and conditions within this agreement and the County policy. I understand it is my
responsibility to make the telework arrangement a success. And that failure to adhere to the provisions set forth may
have adverse effects on my employment, and may result in disciplinary action, including but not limited to
immediate termination of the opportunity to participate in the telework arrangement.
Employee Signature:
Date:
Department
Head/Supervisor
Signature:
Date:
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