Date of Request. Signed by the Employer: ........................................................................ Name of Manager: ........................................................................
Date of Request. Employer Approval: ....................................................................
Date of Request. 4. Project/Program Description Clay County entered into a joint maintenance agreement with FDOT in 1996 to maintain the recreational bike trail known as Black Creek Bike Trail. The Construction and Maintenance Agreement was entered into in 2011, acknowledging that DEP would construct the 8 mile paved trail and the County would maintain and make repairs. This trail has 3 wooden boardwalk sections that are in need of replacement. These sections are 3200 ft, 180 ft, and 210 ft long with handrails. The County seeks to replace the stringers, decking, and handrails in these three sections with composite wood. No Department of Transportation
Date of Request. 20__ This Advance Request is delivered pursuant to the Loan Agreement. All terms defined in the Loan Agreement shall have the same meaning herein, except as expressly defined in this Request for Advance or as set forth in the Availability Statement.
Date of Request. Signature of employee The employee is to submit this application to the building principal after completion. FOR PRINCIPAL / ADMINISTRATOR USE ONLY The principal is to route this form to the Business Manager after completing this section. Request Approved Yes No Maximum Amount Approved $ Substitute Teacher (account number) Signature of Principal Date: FOR BUSINESS OFFICE USE ONLY APPLICATION APPROVAL The account(s) indicated has unencumbered appropriation at this time to meet the funding approved. Yes No Date: By: Approved: Date: Yes No Signature of Superintendent or designee CODE 8 CODE 9 Appendix B PER 13C Revised 09/2012 METROPOLITAN SCHOOL DISTRICT OF PERRY TOWNSHIP 0000 Xxxxxxx Xxxxxx Xxxxxxxxxxxx, XX 00000 SICK BANK MEMBERSHIP FORM In accordance with Article II, Section 4, of the current ratified Agreement between the Board and the Association, all teachers shall become members of the Sick Bank by completing the appropriate form and by contributing the individually required number of days. “I specifically acknowledge and agree that the granting of days from the Sick Bank shall be at the sole discretion of the Sick Bank Committee or, in the event of an appeal, the Appeal Board, and that all decisions of the Sick Bank Committee or the Appeal Board will be final and binding. I further agree to abide by such decisions and to indemnify and hold harmless the Perry Education Association, the Metropolitan School District of Perry Township, the Sick Bank Committee, and the Appeal Board and all of their agents for any loss they may sustain as a result of any claim or legal proceedings I may bring against any of them with respect to a decision made by any of them concerning the application.” Employee School (print or type name) Date (signature of individual) Appendix C Form SBC 1 Revised 09/2012 MSD of Perry Township and Perry Education Association SICK BANK USE APPLICATION A sick bank member may qualify for a grant from the Bank only after his/her own accumulated sick leave is depleted. Name School Date of Application The above-named employee herewith requests to receive a grant of days from the Sick Leave Bank, beginning and ending . (date of first unpaid working day) (date of last unpaid working day) List below the first five (5) days of absence due to illness* after your sick leave has been depleted. Month Date Year 3. 20 4. 20
Date of Request. 1.1 [Date]
