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Payroll Authorization Slip for Cellular Charges
Name:_____________________________________________________________________________
Department Name:___________________________________________________________________
Social Security Number:_______________________________________________________________
Cellular Phone Number(s):_____________________________________________________________
I authorize Weber County to deduct my current AT&T Wireless charges and a $1.00 per month administration fee, from my first two pay checks each month.
Signature:_______________________________________________Date:_______________________
Code of Conduct Acknowledgment Form
I understand there is a copy of the County Personnel Policies and Procedures and the Weber County Merit System Ordinance in my department which I may review during working hours.
I agree to submit to a physical examination, if required. I understand that no contract exists between Weber County and myself with respect to length of employment, salary ranges, movement within salary ranges, employee benefits, or other conditions of employment.
I acknowledge that I have read and understand the Weber County Code of Conduct and that I agree to comply with all of its provisions. I understand that I may be disciplined (which may include termination) for violations of this Code of Conduct or other Weber County Policies and Procedures. I agree to be responsible for County property and equipment issued to me and to pay for property and equipment not returned.
_________________________________________
Employee Signature |
_______________________________
Date |
_________________________________________
Employee's Department |
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Compensatory Time Program Participation Request
I, the undersigned employee of the ______________________________________ Department have been advised by the Department Director that I am eligible to participate in the Compensatory Time Program when I am requested to work overtime. I hereby volunteer to work overtime and to have such overtime paid through the Compensatory Time Program which allows me to earn 1 ½ hours of compensatory time for each hour of overtime worked.
I understand that if I am working in the Compensatory Time Program I may be requested to work overtime before another employee who is not participating in the Compensatory Time Program.
__________________________________________
Print Name
__________________________________________
Social Security Number
__________________________________________
Signature
__________________________________________
Date
Weber County
Disclosure Statement
(Utah Code Annotated, Title 17, Chapter 16(a))
This statement should be completed by all Weber County employees and by all persons serving on County committees, agencies, boards, or any person appointed to a position by the Weber County Commission. After completion, the statement should be filed with the Weber County Commission.
- Are you an officer, director, agent, employee, or owner of 10% or more of a business which does, or anticipates doing, business with Weber County or that is subject to regulation by Weber County? If so please list:
- The name and address of the business;
- The position you hold with the business;
- The nature of the business's association with Weber County.
- Do you have a personal interest, or investment that creates an actual or potential conflict with your public duties? If so, please describe the nature of your investment.
- Do you receive compensation for assisting any person or entity in transactions involving Weber County? If so, please provide:
- The name and address of the person or business you assist;
- A brief description of the nature of the service you perform.
Signed and sworn to this _______ day of ________________________, 20_______.
______________________________________
______________________________________
(Printed name and County Department)
Pre-Employment Drug Free Workplace Policy
Acknowledgment and Drug Testing Agreement
I, _________________________, understand that Weber County is committed to providing a drug free work environment which ensures safety and encourages the personal health and productivity of its employees. I hereby acknowledge that I have been notified of Weber County's Drug Free Work Place Policy and that I have been given a copy of that policy to read. I have been notified that said policy requires that I undergo and successfully pass a drug test as a condition precedent to my employment. Further, I understand that while I am employed by Weber County I may be subject to drug testing under certain circumstances which are specified in the Drug Free Work Place Policy.
I hereby acknowledge and agree that my employment is conditional upon successfully passing the drug test. I agree to report for a drug test at WorkMed, 1355 West 3400 South, Ogden, Utah, within 24 hours of my receipt of the Authorization for Medical Treatment form provided to me by the Weber County Human Resources Department.
I understand and agree that if I do not successfully complete the drug test within 24 hours of receiving the authorization for medical treatment form, that I may lose the position that has been conditionally offered to me.
______________________________________
Employee Signature |
_________
Date |
_________________
Time |
______________________________________
Witness Signature
Grant Funded Employees
A grant funded employee is an employee whose position with the County is funded primarily by grant funds for the purpose of performing work required by the grants. Positions of this kind are intended to exist only so long as the funding from the grant continues. Grant funded employees have all of the same rights as other County employees except as follows:
A grant funded employee does not have any right of continued employment beyond the period of the grant funding. While it is expected that this grant will last from ________ through________, there is no guarantee that the grant will last the entire period. The position will exist only so long as the funding from the grant is available.
A grant funded employee whose employment is terminated due to the lack of grant funding does not have any rights under Section ________ in the Weber County Personnel Policies and Procedures.
A grant funded employee does not have any right to the County's grievance procedure for the purpose of grieving either the termination of their employment or a reduction in their work hours because of the loss of grant funding, regardless of the reason for the loss of funding.
I have read and understand the above statements and I agree to these conditions of employment.
_________________________________________
Signature |
_________________________
Date |
Weber County Monitoring Policy Acknowledgment
All workplace technology including phone systems, computers, E-mail or Voice mail systems, audio systems, fax machines, cash registers, and surveillance video equipment are business equipment owned by Weber County. All communications and or activity on this equipment is considered property of the County. Employees should have no expectation of personal privacy when they use these County owned systems.
Communications on some County owned equipment may be subject to monitoring to insure that the technology is used properly. This monitoring will be done to facilitate quality control and to prevent customer and or employee misconduct. Any employee I.D. numbers or passwords used by employees are to prevent unauthorized access by other employees, and should not be considered as creating any right or expectation of privacy for the employee who uses the password. Employees are strongly advised not to share their I.D. numbers or passwords with any other employee. Sharing of this information could be grounds for disciplinary action.
No use of County equipment should involve material or comments which may be viewed as unprofessional, harassing, discriminatory, suggestive and or sexual in nature.
Video surveillance equipment in and around County owned property is for business related matters and for customer and employee protection. No employee or customer should have an expectation of privacy when in view of such equipment.
Employees violating this workplace policy are subject to disciplinary action up to and including termination.
I have read and understand this Policy.
_________________________________________
Employee Signature |
_________________________
Date |
Release of Liability to Provide Information
I hereby authorize release of all information Weber County, its Human Resources Department, or the departments I have worked for may have concerning me, whether on record or not. I also release Weber County and its employees from any liability for any damage whatsoever of issuing same. This release expires two years from date indicated below.
_________________________________________
Signature |
_________________________
Date |
Sex Harassment Policy Receipt and Review Acknowledgment
| I, |
________________________________________________,
(Please print full name) |
certify that: |
- I have received a copy of Weber County's Sex Harassment Policy enacted by the Board of County Commissioners on the 30th day of November, 1994;
- I have been given time to carefully read the policy;
- My supervisor or a County training representative has answered any questions I have regarding this policy;
- I understand that two investigators have been appointed by the County Commission, one male and one female, to investigate sex harassment complaints, and will, to the best of their ability, honor my anonymity if I so require.
- I have been made aware that the sex harassment hotline number is 399-8355 or 399-TELL.
- I understand that I am encouraged to report any incident of sex harassment to my supervisor, the appointed investigators, the sex harassment hotline or the Department of Human Resources.
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_________________________________________
Signature |
_________________________
Date |
_____________________________________________
Department Name
____________________________________________
Social Security Number
Waiver of Merit Rights and Transfer Agreement
I, the undersigned employee, acknowledge and agree as follows:
- I am presently an employee of the _______________ Department with merit rights as defined in the State Code and in the County Merit Policies and Procedures. I achieved my status by successfully completing a probationary period which ended _______________. I understand as a merit employee with the _____________________ Department, my employment may not be terminated without cause. I have learned of an open position in the _____________________ Department and desire to apply for, and accept that position if the offer is extended.
- I have not been coerced or forced to apply for the position, but I am voluntarily applying for that position knowing that I am giving up certain merit rights if I take that position.
- I recognize that a transfer to this position terminates some of my basic merit rights, including rights of seniority and termination of my employment for cause. By requesting and accepting this transfer I understand that I will be placed on a probationary status for a period of _______ months, and that my employment with Weber County may be terminated without cause during that period. I understand that I will not achieve full merit status until my probationary period has been successfully completed.
- I acknowledge that I have no right to transfer back into my previous department nor will I have any seniority in the department I am transferring to except as may be accumulated after the transfer is complete.
- I have had the opportunity to discuss this agreement with my Department Director and/or Elected Official and hereby acknowledge that I understand this agreement in full.
- I have also had the opportunity to contact legal counsel of my choice and have been encouraged to consult with legal counsel before entering into this Agreement.
- This Agreement shall be interpreted and construed in accordance with the laws of the State of Utah, and constitutes the full Agreement between __________________________________ and Weber County.
Dated this ___________ day of _________________, 20_____.
Signature____________________________________
Giving Employment References
Before giving an employment reference:
- Contact the Human Resources Department and verify a release of liability form is on file.
- Check out the legitimacy of the person calling.
- Make sure the inquiry is legitimate by asking what position the former employee applied for.
- Determine whether the former employee has given permission and/or a waiver to allow the prospective employer to talk with you.
- State the information you are giving is confidential, cannot be passed on, and should be treated confidentially. Say "I am providing information only because you requested it and only for professional purposes."
When giving an employment reference:
- What you say must be true.
- Make sure all released information is documented.
- What you say must be relevant to job performance.
- What you say must have a bearing on the new job.
- Only provide information which relates to the job and job performance in question. If the new job has no bearing on the old job, indicate you have no feel for how former performance has a bearing on the new position.
- What you say must not be said for purposes of harming a former employee but only to answer questions.
- Do not volunteer information, respond directly to the question.
- Keep a brief record of who called, what was asked, what was provided, and the date and duration of the conversation.
- Do not answer questions such as "Would you rehire this person? Would you recommend applicant for position sought?"
- Do not answer questions "off the record." All questions are clearly discoverable in a Iawsuit.
- Do not provide vague statements such as "He was average." Provide answers which match the documentation exactly.
- Do not make subjective statements which cannot be backed up by documentation.
- Be sure to state why you made the opinion. "He received a rating of unsatisfactory on job attendance because he was absent from work five times during the month of May."
- Affirm or deny information that was given the inquirer by the former employee and indicate if you have documentation to back up your statement.
- If the former employee has been involved in some very serious offense relating to health and safety of others instead of such things as poor performance then the prospective employer should not be misled. Be sure documentation backs up what you say and tell the truth.
- When responding to a written inquiry, do not fill in the blanks or check choices which do not match exactly the documentation you possess.
Checking Employment References
Before checking an employment reference:
- Contact the Department of Human Resources and verify a release of liability form is on file. The application contains a waiver.
- Check out the legitimacy of the person you are calling.
- Make sure the reference has legitimate knowledge and authority to answer your questions.
- Determine whether the applicant has given permission and/or a waiver to allow the former employer to talk with you.
- Treat the information you are receiving as confidential, do not pass it on.
When checking an employment reference:
- Ask only questions which pertain to the job.
- Do not volunteer information on what other references have provided.
- Keep a brief record of who was called, what was asked, what was provided, and the date and duration of the conversation.
- Do not ask questions "off the record." All questions are clearly discoverable in a lawsuit.
- Ask questions which reveal prior job performance and performance characteristics of the applicant.
- Do not ask vague questions such as "Was he an average performer." Ask questions such as "How well did he reconcile bank statements?"
- Do not make subjective statements about what is being said to you by the former employer or indicate whether you will or will not hire the applicant.
- Confirm information that was given you by the applicant. Confirm it precisely, do not put it into your own words.
- Do not call the applicant's friends or relatives.
- Ask the former employer for additional names you can call.
- Do not ask any questions which are illegal for you to ask the applicant.
- Verify the education and training claimed by applicant.
- Thank the person for their responses.
Sample Questions
- Verify dates of employment.
- Verify salary level.
- Ask what is history of attendance.
- What is the official title of the position held?
- What are the minimum requirements?
- Did applicant supervise? How many and what levels?
- What was primary responsibility?
- What size budget was applicant responsible for?
- What was their best contribution to organization?
- Was he/she cooperative with superiors and coworkers?
- How good are their communication skills?
- Were you satisfied with the work output?
- Is employee eligible for rehire?
- Did the applicant receive regular employment evaluations?
- Was the applicant the subject of disciplinary action while employed?
- What is the reason applicant left employment?
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