Telework Agreement | Page 1 of 4
Telework Agreement
Employee Name: State ID:
Job Title: Department:
TELEWORK SCHEDULE
Effective Date of Telework Schedule (mm/dd/yyyy):
Expiration Date of Telework Schedule (mm/dd/yyyy)*:
The following will be your normal telework schedule.
All overtime work must be pre-approved by your supervisor.
Day of the Week Work Hours
Example: 8:00 AM 4:30 PM
Lunch
Example: 12:00 AM – 1:00 PM
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
TELEWORK LOCATION
Location Address:
City: State: Zip:
Telework Phone Number: Telework Fax# (if applicable):
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PERSONAL ACTIVITIES
Telework hours are regular work hours and may not be used for personal activities, including but not limited to
dependent care or errands. Just as with regular work hours, teleworkers are expected to follow agency vacation and
sick leave policies and procedures to request time off from Telework to engage in personal activities.
EQUIPMENT/SUPPLIES
You are responsible for obtaining, maintaining, and protecting all state equipment and supplies for use during
telework. You must follow normal supply procurement and expense reimbursement procedures for obtaining
supplies (e.g. supervisor approval).
All state-owned equipment and supplies must be returned when the Telework
Agreement ends.
Please list any state equipment and/or supplies to be used at the telework location.
Item Type Fixed Asset Number Serial Number
C
OMMUNICATION/AVAILABILITY
You must be available and accessible during the telework schedule for customers, co-workers, and
supervisors/managers.
L
ist communication expectations of teleworker. Include frequency or type of contact, process for requesting leave,
contact during telework hours, expected response time, etc:
(Example: 1) Maintaining availability during identified work hours; 2) Use College Outlook calendar to document appointments,
meetings, workgroup interactions, project work; etc.)
Telework Agreement | Page 3 of 4
WORK ASSIGNMENT
Typical assignment(s) to be completed by Employee at the remote work location:
SPECIAL CONDITIONS
List any additional instructions, conditions, restrictions, or exceptions relating to this Telework Agreement:
AGENCY TELEWORK TERMS AND CONDITIONS
A. This Agreement in no way alters my employment relationship with the Ridgewater College or my obligation
to observe all applicable campus rules, policies and procedures. All existing terms and conditions of
employment, including but not limited to my position description, salary, benefits, vacation, leave and
overtime remain the same as if I worked only at my regularly assigned place of employment.
B. Your telework location is an extension of your assigned permanent/principal work location. As such, you
are responsible for complying with all laws, rules, regulation, and policies regarding data practices and data
privacy. You must safeguard data as to preserve the security of data as required by the Minnesota
Government Data Practices Act and Agency policy. Current State of Minnesota data privacy training must
be on file. If unsure, please review required training in Employee Self Service.
scheduled work hours if necessary.
C. The operational needs of Ridgewater College take precedence over this Teleworking Agreement. After
being provided as much advance notice as possible, I must report to Ridgewater College on a scheduled
telecommuting day when required by my supervisor.
D. Only Ridgewater College approved and scanned software will be used for connecting with Ridgewater
College’s network from the remote worksite. I will follow all Ridgewater College information security rules,
copyright laws and manufacturers’ licensing agreements.
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E. Ridgewater College equipment located at my remote work site is subject to all policies and restrictions
related to use of state-owned property. I am responsible for any and all equipment and software that is
used at the remote work site, and I accept financial responsibility for any equipment that is lost, stolen or
damaged because of my negligence, misuse or abuse. I will read and comply with the Ridgewater College’s
property administration procedures, including completion of required documents and information resource
policies and procedures.
F. If
I print protected student or employee information (PSEI) at my remote work site, I will ensure that all
materials will be shredded appropriately. I will contact my supervisor immediately if private data is
exposed.
G. I will submit status reports describing tasks performed and/or completed in the format requested by my
supervisor. If my position is considered non- exempt under the Federal Fair Labor Standards Act, I will
obtain the advance approval of my supervisor before working more than 40 hours in a work week. I will not
receive state compensatory time while teleworking, and I must obtain supervisory approval before taking
leave.
H. I am liable for damages to my personally-owned equipment resulting from teleworking. Ridgewater College
will not be responsible for operating costs, home maintenance, or any other incidental costs e.g. utilities,
telephone, and insurance, associated with the use of my residence for teleworking unless specifically
provided otherwise in this Agreement.
I. This Agreement does not constitute an employment contract and it does not create a property interest in
employment.
J. Ridgewater College reserves the option to terminate the Agreement without notice.
K. I will be available during the included telework schedule for students, employees, and supervisors/
managers via telephone, e-mail or via teleconferencing with the exception of approved time off/leave.
L. I am covered by the state’s Workers’ Compensation laws while in telework
status so long as I am acting in
the course and scope of your employment. It is my responsibility to report ALL accidents/injuries that occur
while I am teleworking to my supervisor immediately. The State of Minnesota and Ridgewater College do
not assume responsibility for third party injuries or property damage that may occur at the telework
location. I cannot hold in-person, work related meeting in a telework location at my home; meetings may
be conducted in a public setting or via web cam, phone conference, Skype, Zoom or by other digital means.
The a
bove conditions may change or be modified as warranted.
Employee Signature: Date:
Supervisor Signature: Date:
Original to Personnel File Copy to Employee Copy to Supervisor
TO SAVE DOCUMENT: After typing your signature above, to save the file click on Printer icon on toolbar above, click on
the "Printer:" dropdown arrow and choose "Microsoft Print to PDF". Name and save the file to your computer to a place
where you can find it to email it to your supervisor.