Compensation for Working Public Holiday Form
(Full Time Employees Only)
Employee Name: Mohawk ID:
Department: Job Title:
Date of Public Holiday:
Public pay is based on the regular wages worked and paid in the previous pay period prior to the public
holiday, divided by the number of days worked in the same period. Regular wages do not include premium pay
(e.g. overtime) or public holiday pay.
Compensation for working public holiday:
Employees, where operational requirements dictate, may on occasion be requested to work on a public
holiday.
The employee has agreed to work hours on the holiday named above and will be compensated
for the time worked in accordance with their terms and conditions of employment or collective
agreement.
Employees who work on a public holiday must make the following election, in accordance with legislation,
prior to the Public Holiday.
Public Holiday Pay:
The employee will substitute the public holiday dated above on
(mm/dd/yyyy)
Work the public holiday and be compensated at regular pay rate times 1.5 for the hours worked
on the public holiday, and substitute another day off which will be compensated at their regular
rate of pay. The substituted day must be documented at the time the employee works the public
holiday.
OR
The
employee has elected to receive public holiday pay only.
Work the public holiday, and be compensated at regular pay rate times 1.5 for the hours worked
on the public holiday and in addition receive public holiday pay. (The employee will not receive
another day off as a substitution day).
This form must be completed and submitted to Payroll by the next pay cut-off after the public
holiday above occurs.
Employee’s Signature: Manager’s Signature:
Date of the day this completed form was provided to the employee:
Once complete please attach to Overtime Form and send to payroll department.
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