In order to process your request, we will need supporting documentation.
The documentation requirement is listed below and corresponds to the reason you selected on
the first page:
1) The federal, state, or local quarantine or isolation order related to COVID-19
2)
The Health Care Provider’s contact information such as Name, Address, and Telephone
Number.
3)
The Health Care Provider’s contact information such as Name, Address, and Telephone
Number.
4)
The name and contact information for the individual you are caring for and their health
care provider’s contact information such as Name, Address, and Telephone Number.
5)
Your child’s name and contact information of their school or childcare provider that is
unavailable due to COVID-19 precautions.
6)
The Health Care Provider’s contact information such as Name, Address, and Telephone
Number.
For leave reasons (1), (2), or (3): employees taking leave shall be paid at either their regular rate
or the applicable minimum wage, whichever is higher, up to $511 per day and $5,110 in the
aggregate (over a 2-week period).
For leave reasons (4) or (6): employees taking leave shall be paid at 2/3 their regular rate or 2/3
the applicable minimum wage, whichever is higher, up to $200 per day and $2,000 in the aggregate
(over a 2-week period).
For leave reason (5): employees taking leave shall be paid at 2/3 their regular rate or 2/3 the
applicable minimum wage, whichever is higher, up to $200 per day and $12,000 in the aggregate
(over a 12-week period—two weeks of paid sick leave followed by up to 10 weeks of paid expanded
family and medical leave).
If you are requesting leave for reason 4, 5 or 6, please indicate if you wish to use your own accrued
time off to supplement the 1/3 that you will not be paid.
Yes, I wish to use my accrued time off to supplement the 1/3 rate that will be unpaid.
No, I wish to be docked for the 1/3 rate that will be unpaid.
If you have any questions, please email Leavesofabsences@escco.org