Fillable City of Oakland Telecommute Agreement and Application (City of Oakland)

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City of Oakland Telecommute Agreement and Application (City of Oakland)

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File type: PDF

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City of Oakland Telecommute Agreement and Application
Name: __________________________________
Title __________________________________
Email: __________________________________
Work phone: __________________________________
Department: __________________________________
Supervisor Name: ________________________________
Supervisor Phone: _______________________________
Supervisor Email: _______________________________
1. How frequently would telecommute? ________________
2. What day(s) of the week can you telecommute?
MON ____ TUE ____ WED ____ THUR ____ FRI _____
3. Describe the typical assignments to be worked on at home:
4. Employee agrees to call-in to obtain messages at least ____
times a day while working home.
5. The employee agrees to work at the following location:
Address: ________________________________________
Zip:State: _City: _____________________ ___ ________
Home phone: __________________
Cell phone: __________________
City of Oakland
Telecommute Agreement and Application
2020
TEMPORARY TELECOMMUTE AGREEMENT
I unders
tand and agree to the following terms and conditions:
The temporary telecommute policy is in effect for the duration of the Local Emergency, which is currently in
effect through May 10, 2020.
My manager/supervisor has the authority to discontinue this Telecommuting Agreement at any time.
I must regularly demonstrate the ability to work independently, communicate regularly and effectively with my
manager/supervisor and other employees, and maintain a high degree of self-motivation.
My manager/supervisor will provide performance expectations associated with this telecommuting
arrangement. I must meet these expectations along with all other expectations for the Telecommuting
Agreement to continue.
I can provide a work environment that is free of interruptions and distractions.
I am expected to devote the same time and attention to work at a telecommuting site as I would devote if the
work were performed at a City of Oakland facility.
My telecommuting worksite is safe and healthy, free from recognized hazards that are likely to cause serious
injury or death.
If I use a home computer to create or store work-related documents, I will ensure those documents are kept
safe and confidential.
I will not share my work-related documents, passwords, etc. with anyone not authorized to receive them.
It is expected that employees will not need to store work-related documents on a home computer. However, if
I use a home computer to create or store work-related documents, I will comply with records retention policies
related to those work documents and fully cooperate in the production of public records requested under state
law. This obligation shall survive the expiration of this Temporary Telecommuting Agreement and/or my
separation from employment with the City.
Should workplace documents stored on my home computer become subject to production for any reason, I will
fully cooperate with the City of Oakland in producing documents or other lawful requests. This obligation shall
survive the expiration of this Telecommuting Agreement and/or my separation from employment with the City.
I have no entitlement to telecommute and I do not acquire such a right by being provided the opportunity to
telecommute for any period of time.
I cannot grieve the decision of my manager/supervisor to not grant, not renew, or revoke the opportunity to
telecommute.
I have read, understood, and agree to the above Temporary Telecommuting Agreement terms and conditions. I
understand and accept the performance expectations and rules identified by my manager/supervisor. Questions about
this Telecommuting Agreement and arrangements should be directed to my supervisor. I will abide by the City of
Oakland’s Temporary Telecommuting Policy or applicable collective bargaining agreement provision. My signature
below signifies my understanding, agreement, and acceptance.
Employee Print Name: ______________________________________________
Employee Signature: ____________________________________ Date: ______________
Manager/Supervisor Signature: ____________________________ Date: ______________
DEPARTMENT DIRECTOR APPROVAL
Approved
Denied
Comments:
Departm
ent Director Signature and date: _________________________________
Return completed Telecommuting Agreement to Human Resources at 150 Frank H. Ogawa Plaza, 2
nd
Floor Personnel
Front Desk
Copi
es of signed agreement forms must be retained by the employee and supervisor.
City of Oakland
Telecommute Agreement and Application
2020
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City of Oakland Telecommute Agreement and Application (City of Oakland)

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Completed 24 November 2020

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