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Page 1 of 6 CITY OF WOODBURN-REMOTE WORK ARRANGEMENT Remote Worker Name: Supervisor Name: Department: Division: Classification: Date remote work will begin: Remote Work address: Remote Work phone: Remote Work Evaluation and Review: Criteria that will be used to evaluate the success of the Remote Work Arrangement: Remote Work Arrangement will be evaluated (Quarterly, Bi-Annually): First Remote Work Arrangement review date: Remote Work Schedule: The employee agrees to perform agreed upon duties and be accessible to the City on the following Remote Work days: Mon Tue Wed Thurs Fri Sat Sun Start Time End Time Total Hours Accessibility and Communication: The employee agrees to structure their time to ensure attendance at required meetings and events as designated by their supervisor. The employee further accepts the special responsibility as a remote worker to facilitate communication with customers and colleagues while on a remote work schedule. ---PAGE BREAK--- Page 2 of 6 The employee agrees to be available during scheduled work hours on remote work days using the following methods (check all that apply): Phone Voice mail/answering machine E-mail Text Other: Describe how incoming calls at the central office will be handled on remote work days: The employee agrees to check his/her voicemail and/or call in to the central office for messages times per day at approximately the following time(s) of day while working at an alternative work site: Long distance phone charges made by the employee while working at an alternative worksite will be handled as follows usage of City cell phone, calling card, reimbursement, etc.): Other accessibility and communication issues: Performance Measures: The employee agrees to keep their supervisor regularly informed of the progress on remote work assignments and agrees to keep the supervisor informed of any problems experienced while remote working. Tasks to be completed while remote working Timeframe for completion Method and frequency tasks will be reported to supervisor How tasks will be measured for success ---PAGE BREAK--- Page 3 of 6 Equipment/Services to be Used at the Remote Work Site: The following equipment/services will be provided to the employee by the City (check all that apply): Phone Printer Computer Other equipment not mentioned above: Remote network access provided (VPN)? Yes No The employee will provide the following equipment/services (check all that apply): Phone Voice mail Office furniture Computer Printer Internet Service Other equipment not mentioned above: Reimbursement Information: Generally, the City does not reimburse costs associated with remote working and will not pay or reimburse the employee for: • Time involved in travel between the official workstation and the remote work site. • Purchasing computer equipment, internet service, or printer/ink cartridges. • Any purchase, service charge, or cost related to remote work that is not specified in this arrangement. The City agrees to reimburse the employee for the following expenses related to Remote Work: City Property and Records: The employee agrees that documents or other records required to be retained and are used, developed or revised while remote working will be securely transferred no later than the following workday to the official workstation. The employee understands and agrees that all equipment, records, files, manuals, forms, materials, supplies, computer programs and other materials furnished by the City, or generated or obtained on behalf of the City during the course of employment shall remain the property of the City. The employee understands that the employee is the holder of this property for the sole use and benefit of City and will take all reasonable precautions to safely keep and preserve ---PAGE BREAK--- Page 4 of 6 such property, as well as maintain confidentiality except as disclosure is required in normal business operations. The equipment, supplies, and other property provided by the City should be returned within 2 days of City’s request unless other arrangements are agreed to. Upon termination of employment, all equipment, supplies, documents, and other City property, must be returned to the City. In the event the telework schedule set forth in the Arrangement ends, the Employee's obligation to return City property continues. Employee Owned Property and Equipment: Any employee owned property and equipment used for City business may subject to a public records request, subpoena, court or administrative order, or privacy/security violation investigation and may require the employee to provide the City with full access to such equipment. If the equipment is a personal computer, the employee understands the City may need to copy the contents of the hard drive. Taxes and Insurance: City makes no representations on the personal tax and insurance implications of this telework arrangement; it is the Employee's obligation to address these issues on his/her own. Employee Computer Security: The employee understands they are responsible for following all security guidelines issued by IT including ensuring software and applications are currently updated with security patches, maintaining a personal firewall, secure WIFI, and updated anti-virus and anti-spyware programs, and keeping their operating system configured securely. Health, Safety and Ergonomics: The employee acknowledges the City has the right to “short-notice” inspections, which may occur after an incident or accident occurs. The employee understands she/he may request Risk Management training and/or an assessment of their home work area to provide strategies to improve the health, safety and ergonomic well- being of the remote working employee. Has the employee completed and the supervisor reviewed the Remote Work Safety Checklist? Yes No Dependent Care: Does the employee have dependents requiring care during remote work hours? Yes No If yes, does the employee have dependent care to relieve the employee from primary-care responsibilities during remote work hours? Yes No ---PAGE BREAK--- Page 5 of 6 If no, has the employee gone over with their supervisor how they will address this issue per the policy? Yes No Terms of Employment: The employee understands that this Remote Work Arrangement does not otherwise alter the basic terms and conditions of employment including wages, overtime compensation, insurance benefits, paid leave, salary reviews, workers compensation, etc. The employee further understands that City policies, rules, and practices shall apply at the remote work site, including those governing communicating internally and with the public, employee rights and responsibilities, facilities and equipment management, financial management, information resource management, purchasing of property and/or services, and safety. Termination of Remote Work Arrangement: Remote Working is a privilege rather than a universal employee benefit or right. The City has the right to offer remote work to an employee and to unilaterally terminate a Remote Work Arrangement at any time. Employees do not have a property interest in Remote Work. In no circumstances are employees entitled to due process related to any City decision on Remote Work issues, including approvals denials, or a City decision to discontinue a Remote Work Arrangement, and all such decisions are not subject to grievance. Acknowledgment: I have read and understand this arrangement and the remote work policy, and agree to abide by and operate in accordance with the terms and conditions described in both documents. I agree that the sole purpose of this arrangement is to regulate remote work and that it constitutes neither an employment contract nor an amendment to any existing contract or City policy. Both parties agree that this Arrangement supersedes any previous written or oral arrangements between them relating to the same subject matter and represents the entire arrangement regarding telework arrangements. The Employee agrees to abide by the terms stated in this Arrangement and its attachments. The undersigned acknowledges they have read, understand, and agree to the terms and conditions of this Telework Arrangement: Employee Date Supervisor Date SIGN SIGN ---PAGE BREAK--- Page 6 of 6 Department Director Date: CC: Personnel File Adopted 9/2021 SIGN