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City of Ramsey DRAFT Telecommuting Working Agreement <br />4 <br />C <br />au <br />c <br />0 <br />E" <br />W <br />1. Remote work location: • Employee residence • Other <br />(Specify) <br />Employee Name <br />Street Address <br />City <br />State <br />Zip <br />Telecommuting will benefit the City of Ramsey by: <br />Schedule <br />2. Teleworking schedule • On a weekly basis M Tu W Th F •Occasional basis <br />• On a monthly basis (regular commuting days e.g., 1st Tu): <br />3. Core hours <br />Equipment <br />1. <br />City of Ramsey equipment (if any) provided for use at remote work locations: <br />Description <br />Approved by IT <br />(if applicable) <br />5. <br />Databases and information systems the employee will have access <br />to from remote work location (if any): <br />6. <br />Non City of Ramsey equipment, software and data permitted to be used. <br />Items <br />Contacts <br />7. Frequency and type of contact between employee and supervisor on teleworking days will be: <br />8. Employee will monitor telephone calls from the remote work location and will respond to calls as if at permanent work <br />location. • Yes • No. If no, Employee will call the permanent work location at least times per day. <br />9. Conditions/expectations/performance measures/agreed upon by the employee and supervisor: <br />My signature below indicates that I have read and accept the terms <br />and conditions of this Agreement as described in the Interim City of <br />Ramsey Administrative Telecommuting Policy <br />I agree that this employee may telecommute with the conditions <br />identified in the City of Ramsey's interim telecommuting policy. <br />Employee Signature <br />Date: <br />Signature of City Administrator <br />Date: <br />Department Head Signature: <br />Date: <br />Human Resources Manager: <br />Date: <br />