PLEASE PRINT LEGIBLY. This form may only be submitted by the test center administrator, designated liaison or agency head as shown in TCLEDDS or otherwise accompanied by a memorandum on departmental letterhead to support an alternate agency representative. Any change in the testing xxxxxxx or testing administrator requires notification to BOTH TCOLE AND /PCI. For TCOLE contact Xxxxx Xxxxxx at xxxxx.xxxxxx@xxxxx.xxxxx.xxx; and “Productivity Center” (PCI) at xxxxxxx@xxxxxxx.xxx for information. Testing Center Name Testing Center ID Number Submittal Date Submitted by: [ ] Agency Head [ ] Test Center Administrator [ ] PCI Liaison / Lead Xxxxxxx First Name Last Name Phone Email Change in testing xxxxxxx information #1 (A Testing Xxxxxxx must read the Electronic Testing Manual available on the TCOLE web site.) [ ] Add [ ] Remove [ ] Info change only TCOLE PID (if applicable) First Name M.I. Last Name Suffix Mailing Address City State Zip Work Phone Cell Phone Email Change in testing xxxxxxx information #2 (A Testing Xxxxxxx must read the Electronic Testing Manual available on the TCOLE web site.) [ ] Add [ ] Remove [ ] Info change only TCOLE PID (if applicable) First Name M.I. Last Name Suffix Mailing Address City State Zip Work Phone Cell Phone Email Change in test center administrator or lead xxxxxxx information The “Testing Center Administrator” is the person designated as the liaison or point of contact between TCLEDDS/PCI and the testing center. [ ] New Administrator [ ] New Lead Xxxxxxx TCOLE PID (if applicable) First Name M.I. Last Name Suffix Mailing Address City State Zip Work Phone Cell Phone Email Change or Addition to the Testing Facility, Software or Access Security Systems, or Other Required Notifications Provide notification of changes of Training Facility name, physical address / location, mailing address or contact information. [ ] Facility/Site Change (Attach Photos for ACE Review) [ ] Software or System Access Security Change/Update [ ] Other Notification: (Specify) Primary Contact Name Phone Email Details: (Attach additional documentation pages if necessary.) By signature below I attest that the above information is true, accurate and correct and I am authorized to submit this document to TCOLE and PCI. / / (Type or Print) Name Title Signature (Typed or Electronic Not Accepted) Date Submit 1 copy via email to xxxxxxx@xxxxxxx.xxx and 1 copy via email to xxxxx.xxxxxx@xxxxx.xxxxx.xxx.
Appears in 2 contracts
Samples: www.tcole.texas.gov, www.tcole.texas.gov
PLEASE PRINT LEGIBLY. This form may only be submitted by the test center administrator, designated liaison or agency head as shown in TCLEDDS or otherwise accompanied by a memorandum on departmental letterhead to support an alternate agency representative. Any change in the testing xxxxxxx or testing administrator requires notification to BOTH TCOLE AND /PCI. For TCOLE contact Xxxxx Xxxxxx at xxxxx.xxxxxx@xxxxx.xxxxx.xxx; and “Productivity Center” (PCI) at xxxxxxx@xxxxxxx.xxx for information. Testing Center Name Testing Center ID Number Submittal Date Submitted by: [ ] Agency Head [ ] Test Center Administrator [ ] PCI Liaison / Lead Xxxxxxx First Name Last Name Phone Email Change in testing xxxxxxx information #1 (A Testing Xxxxxxx must read the Electronic Testing Manual available on the TCOLE web site.) [ ] Add [ ] Remove [ ] Info change only TCOLE PID (if applicable) First Name M.I. Last Name Suffix Mailing Address City State Zip Work Phone Cell Phone Email Change in testing xxxxxxx information #2 (A Testing Xxxxxxx must read the Electronic Testing Manual available on the TCOLE web site.) [ ] Add [ ] Remove [ ] Info change only TCOLE PID (if applicable) First Name M.I. Last Name Suffix Mailing Address City State Zip Work Phone Cell Phone Email Change in test center administrator or lead xxxxxxx information The “Testing Center Administrator” is the person designated as the liaison or point of contact between TCLEDDS/PCI TCOLE and the testing center. [ ] New Administrator [ ] New Lead Xxxxxxx TCOLE PID (if applicable) First Name M.I. Last Name Suffix Mailing Address City State Zip Work Phone Cell Phone Email Change or Addition to the Testing Facility, Software or Access Security Systems, or Other Required Notifications Provide notification of changes of Training Facility name, physical address / location, mailing address or contact information. [ ] Facility/Site Change (Attach Photos for ACE Review) [ ] Software or System Access Security Change/Update [ ] Other Notification: (Specify) Primary Contact Name Phone Email Details: (Attach additional documentation pages if necessary.) By signature below I attest that the above information is true, accurate and correct and I am authorized to submit this document to TCOLE and PCITCOLE. / / (Type or Print) Name Title Signature (Typed or Electronic Not Accepted) Date Submit 1 copy via email to xxxxxxx@xxxxxxx.xxx and 1 copy via email to xxxxx.xxxxxx@xxxxx.xxxxx.xxxxxxxxxxxx@xxxxx.xxxxx.xxx.
Appears in 1 contract
Samples: www.tcole.texas.gov
PLEASE PRINT LEGIBLY. This form may only be submitted by the test center administrator, designated liaison or agency head as shown in TCLEDDS or otherwise accompanied by a memorandum on departmental letterhead to support an alternate agency representative. Any change in the testing xxxxxxx or testing administrator requires notification to BOTH TCOLE AND /PCI. For TCOLE contact Xxxxx Xxxxxx at xxxxx.xxxxxx@xxxxx.xxxxx.xxx; and “Productivity Center” Grievance Step (PCIPlease Circle) at xxxxxxx@xxxxxxx.xxx for information. Testing Center 1 2 3 Employee Facility Name Testing Center ID Number Submittal Date Submitted by: [ ] Agency Head [ ] Test Center Administrator [ ] PCI Liaison / Lead Xxxxxxx First Name Last Name Phone Email Change in testing xxxxxxx information #1 (A Testing Xxxxxxx must read the Electronic Testing Manual available on the TCOLE web site.) [ ] Add [ ] Remove [ ] Info change only TCOLE PID (if applicable) First Name M.I. Last Name Suffix Mailing Address Address City State Zip Work Phone Cell Phone Email Change in testing xxxxxxx information #2 (A Testing Xxxxxxx must read the Electronic Testing Manual available on the TCOLE web site.) [ ] Add [ ] Remove [ ] Info change only TCOLE PID (if applicable) First Name M.I. Last Name Suffix Mailing Address City State Zip Work Phone Cell Phone Email Change Class Title: DOC Region (Circle) 1 2 3 Corrections Probation DCF APD Supervisor’s Name: State the nature of the grievance including dates, names, and places. Specify claimed Contract Violation(s) by Article and Section number. In order to assist in test center administrator the processing of this grievance, please attach evidence and documentation in support of the grievance if available. CONTRACT VIOLATION: Article(s) and Section(s): Date of alleged violation(s): GRIEVANCE: REMEDY SOUGHT: I authorize the following Grievance Representative to process this grievance on my behalf: Representative’s Name: E-mail Address: Phone: Fax: I understand and agree that the Local Union 2011 has the final authority in processing, presenting and adjusting any grievance, complaint, or lead xxxxxxx information The “Testing Center Administrator” is the person designated dispute, in such manner as the liaison Local Union, its affiliate Officers and/or Business Representative may consider to be in the best interest of the Local Union. I also understand and agree that the Local Union and its Officers and/or Business Representatives may decline to process a grievance, dispute, or point complaint, if in their judgment, it lacks merit. FOR GROUP GRIEVANCES ONLY – The Grievance Representative named above has been designated to act as spokesperson and be responsible for processing the above grievance. The employees included in the group for which this grievance is filed are identified as follows (identify the group by reference to the employees’ job classification(s), work unit(s), and any other relevant identifying information): Xxxxxxxx’s Signature Representative’s Signature Date Date Submitted to Agency Representative: Name: Title: Date: BUSINESS REPRESENTATIVE’S PROCESSING Grievance No. Date Received: Union Representative Xxxxxxx Date met with employer: Facts: Disposition: APPENDIX C REQUEST FOR ARBITRATION SECURITY SERVICES BARGAINING UNIT – STATE OF FLORIDA TEAMSTERS LOCAL UNION NO. 2011 Affiliated with the International Brotherhood of contact between TCLEDDS/PCI Teamsters 5818 E. M.L. Xxxx, Xx., Xxxx. · Tampa, FL 33619 Fax (000) 000-0000 · 1-855-IBT-2011 The Teamsters Local Union No. 2011 [“Teamsters”], representing employees in the Security Services bargaining unit, hereby gives notice of its intent to proceed to arbitration with the following grievance: GRIEVANT NAME: AGENCY (Please Circle): DOC DCF APD Attached is a copy of the grievance as it was submitted at Steps 1 and/or 2 of the grievance procedure for disciplinary grievances, or at Step 3 for contract language disputes, and a copy of the written decision rendered in response to the grievance. I hereby authorize the Teamsters, and the testing centerfollowing representative, to proceed to arbitration with my grievance. [ ] New Administrator [ ] New Lead Xxxxxxx TCOLE PID (if applicable) First Name M.I. Last Name Suffix Mailing Address City State Zip Work Phone Cell Phone Email Change or Addition I also authorize the Teamsters to use, and to provide to the Testing FacilityArbitrator during the arbitration proceedings, Software copies of any materials relevant to the issues raised in this grievance although such materials may otherwise be exempt or Access Security Systems, confidential under state or Other Required Notifications Provide notification of changes of Training Facility name, physical address / location, mailing address or contact informationfederal public records law. [ ] Facility/Site Change (Attach Photos Representative’s Name: Email address: Phone: Fax: Xxxxxxxx’s Signature: Representative’s Signature: FOR GROUP GRIEVANCES ONLY – The Grievance Representative named above has been designated to act as spokesperson and be responsible for ACE Review) [ ] Software or System Access Security Change/Update [ ] Other Notification: (Specify) Primary Contact Name Phone Email Details: (Attach additional documentation pages if necessary.) By signature below I attest that processing the above information grievance. The employees included in the group for which this grievance is truefiled are identified as follows (identify the group by reference to the employees’ job classification(s), accurate work unit(s), and correct and I am authorized to submit this document to TCOLE and PCI. / / (Type or Print) Name Title Signature (Typed or Electronic Not Accepted) Date Submit 1 copy via email to xxxxxxx@xxxxxxx.xxx and 1 copy via email to xxxxx.xxxxxx@xxxxx.xxxxx.xxx.any other relevant identifying information):
Appears in 1 contract
Samples: Agreement
PLEASE PRINT LEGIBLY. This form may only be submitted by the test center administrator, designated liaison or agency head as shown in TCLEDDS or otherwise accompanied by a memorandum on departmental letterhead to support an alternate agency representative. Any change in the testing xxxxxxx or testing administrator requires notification to BOTH TCOLE AND /PCI. For TCOLE contact Xxxxx Xxxxxx at xxxxx.xxxxxx@xxxxx.xxxxx.xxx; and “Productivity Center” Grievance Step (PCIPlease Circle) at xxxxxxx@xxxxxxx.xxx for information. Testing Center 1 2 3 Employee Facility Name Testing Center ID Number Submittal Date Submitted by: [ ] Agency Head [ ] Test Center Administrator [ ] PCI Liaison / Lead Xxxxxxx First Name Last Name Phone Email Change in testing xxxxxxx information #1 (A Testing Xxxxxxx must read the Electronic Testing Manual available on the TCOLE web site.) [ ] Add [ ] Remove [ ] Info change only TCOLE PID (if applicable) First Name M.I. Last Name Suffix Mailing Address Address City State Zip Work Phone Cell Phone Email Change in testing xxxxxxx information #2 (A Testing Xxxxxxx must read the Electronic Testing Manual available on the TCOLE web site.) [ ] Add [ ] Remove [ ] Info change only TCOLE PID (if applicable) First Name M.I. Last Name Suffix Mailing Address City State Zip Work Phone Cell Phone Email Change Class Title: DOC Region (Circle) 1 2 3 Corrections Probation DCF APD Supervisor’s Name: State the nature of the grievance including dates, names, and places. Specify claimed Contract Violation(s) by Article and Section number. In order to assist in test center administrator the processing of this grievance, please attach evidence and documentation in support of the grievance if available. CONTRACT VIOLATION: Article(s) and Section(s): Date of alleged violation(s): GRIEVANCE: REMEDY SOUGHT: I authorize the following Grievance Representative to process this grievance on my behalf: Representative’s Name: E-mail Address: Phone: Fax: I understand and agree that the Local Union 2011 has the final authority in processing, presenting and adjusting any grievance, complaint, or lead xxxxxxx information The “Testing Center Administrator” is the person designated dispute, in such manner as the liaison Local Union, its affiliate Officers and/or Business Representative may consider to be in the best interest of the Local Union. I also understand and agree that the Local Union and its Officers and/or Business Representatives may decline to process a grievance, dispute, or point complaint, if in their judgment, it lacks merit. FOR GROUP GRIEVANCES ONLY – The Grievance Representative named above has been designated to act as spokesperson and be responsible for processing the above grievance. The employees included in the group for which this grievance is filed are identified as follows (identify the group by reference to the employees’ job classification(s), work unit(s), and any other relevant identifying information): Xxxxxxxx’s Signature Representative’s Signature Date Date Submitted to Agency Representative: Name: Title: Date: BUSINESS REPRESENTATIVE’S PROCESSING Grievance No. Date Received: Union Representative Xxxxxxx Date met with employer: Facts: Disposition: APPENDIX C REQUEST FOR ARBITRATION SECURITY SERVICES BARGAINING UNIT – STATE OF FLORIDA TEAMSTERS LOCAL UNION NO. 2011 Affiliated with the International Brotherhood of contact between TCLEDDS/PCI Teamsters 5818 E. M.L. Xxxx, Xx., Xxxx. · Tampa, FL 33619 Fax (000) 000-0000 · 1-855-IBT-2011 The Teamsters Local Union No. 2011 [“Teamsters”], representing employees in the Security Services bargaining unit, hereby gives notice of its intent to proceed to arbitration with the following grievance: GRIEVANT NAME: AGENCY (Please Circle): DOC DCF APD Attached is a copy of the grievance as it was submitted at Step 3 at Steps 1 and/or 2 of the grievance procedure for disciplinary grievances, or at Step 3 for contract language disputes of the grievance procedure, and a copy of the written decision rendered by the Department of Management Services in response to the grievance. I hereby authorize the Teamsters, and the testing centerfollowing representative, to proceed to arbitration with my grievance. [ ] New Administrator [ ] New Lead Xxxxxxx TCOLE PID (if applicable) First Name M.I. Last Name Suffix Mailing Address City State Zip Work Phone Cell Phone Email Change or Addition I also authorize the Teamsters to use, and to provide to the Testing FacilityArbitrator during the arbitration proceedings, Software copies of any materials relevant to the issues raised in this grievance although such materials may otherwise be exempt or Access Security Systems, confidential under state or Other Required Notifications Provide notification of changes of Training Facility name, physical address / location, mailing address or contact informationfederal public records law. [ ] Facility/Site Change (Attach Photos Representative’s Name: Email address: Phone: Fax: Xxxxxxxx’s Signature: Representative’s Signature: FOR GROUP GRIEVANCES ONLY – The Grievance Representative named above has been designated to act as spokesperson and be responsible for ACE Review) [ ] Software or System Access Security Change/Update [ ] Other Notification: (Specify) Primary Contact Name Phone Email Details: (Attach additional documentation pages if necessary.) By signature below I attest that processing the above information grievance. The employees included in the group for which this grievance is truefiled are identified as follows (identify the group by reference to the employees’ job classification(s), accurate work unit(s), and correct and I am authorized to submit this document to TCOLE and PCI. / / (Type or Print) Name Title Signature (Typed or Electronic Not Accepted) Date Submit 1 copy via email to xxxxxxx@xxxxxxx.xxx and 1 copy via email to xxxxx.xxxxxx@xxxxx.xxxxx.xxx.any other relevant identifying information):
Appears in 1 contract
Samples: Agreement
