Common use of School of Social Work Clause in Contracts

School of Social Work. SSW Office of the Xxxx; Research & Development SSW General Instruction; Field Instruction; SWCOS; Continuing Education SSW Welfare & Child Support SSW Xxxx X. Xxxxx Center for F&C SSW The Institute I & I University Operations UO HRS Office of the VP; UO University Operations; Government & Community Affairs UO HRS UO Public Safety Employee Name:‌‌ APPENDIX C TELEWORK REQUEST AND CERTIFICATION FORM Job Classification and Department: Telework Day(s) Requested: Work Hours Requested (if different from hours in customary workplace): Requested effective date: Has the completed Offsite Workplace Check List been submitted?: What are the specific tasks/duties to be performed by the employee when Teleworking? Policy Acknowledgement and Teleworker Responsibilities: I acknowledge that I have read Article 20 of the MOU on Telework as negotiated between AFSCME and the UMB and that I understand and will comply with the employee responsibilities therein described. I further acknowledge that non- compliance with the terms of the policy on Telework may cause the termination of my employee Telework benefits and may lead to disciplinary action. Employee Signature Date Employee Signature Date Department Head Signature Date Xxxx/Vice President (if applicable) Date Executive Director, HRS (if applicable) Date APPENDIX D‌‌ UMB Telework Program - Offsite Workplace Self- Certification Checklist Name: School/Office: Offsite Work Address: Offsite Work Phone: Supervisor: This checklist is designed to assess the overall safety of your remote workplace and to ensure that you have been properly prepared for Telework. Upon completion, you should sign and return this form to your supervisor. Describe the workspace in your remote workplace:

School of Social Work. SSW Office of the Xxxx; Research & Development SSW General Instruction; Field Instruction; SWCOS; Continuing Education SSW Welfare & Child Support SSW Xxxx X. X� Xxxxx Center for F&C SSW The Institute I & I University Operations UO HRS Office of the VP; UO University Operations; Government & Community Affairs UO HRS UO Public Safety Employee Name:‌‌ APPENDIX C TELEWORK REQUEST AND CERTIFICATION FORM Job Classification and Department: Telework Day(s) Requested: Work Hours Requested (if different from hours in customary workplace): Requested effective date: Has the completed Offsite Workplace Check List been submitted?: What are the specific tasks/duties to be performed by the employee when Teleworking? Policy Acknowledgement and Teleworker Responsibilities: I acknowledge that I have read Article 20 of the MOU on Telework as negotiated between AFSCME and the UMB and that I understand and will comply with the employee responsibilities therein described. � I further acknowledge that non- compliance with the terms of the policy on Telework may cause the termination of my employee Telework benefits and may lead to disciplinary action. � Employee Signature Date Employee Signature Date Department Head Signature Date Xxxx/Vice President (if applicable) Date Executive Director, HRS (if applicable) Date APPENDIX D‌‌ UMB Telework Program - Offsite Workplace Self- Certification Checklist Name: School/Office: Offsite Work Address: Offsite Work Phone: Supervisor: This checklist is designed to assess the overall safety of your remote workplace and to ensure that you have been properly prepared for Telework. � Upon completion, you should sign and return this form to your supervisor. � Describe the workspace in your remote workplace:

School of Social Work. SSW Office of the Xxxx; Research & Development SSW General Instruction; Field Instruction; SWCOS; Continuing Education SSW Welfare & Child Support SSW Xxxx X. Xxxxx Center for F&C SSW The Institute I & I University Operations UO HRS Office of the VP; UO University Operations; Government & Community Affairs UO HRS UO Public Safety Employee Name:‌‌ APPENDIX Appendix C TELEWORK REQUEST AND CERTIFICATION FORM Employee Name: Job Classification and Department: Telework Day(s) Requested: Work Hours Requested (if different from hours in customary workplace): Requested effective date: Has the completed Offsite Workplace Check List been submitted?: What are the specific tasks/duties to be performed by the employee when Teleworking? Policy Acknowledgement and Teleworker Responsibilities: I acknowledge that I have read Article 20 of the MOU on Telework as negotiated between AFSCME and the UMB and that I understand and will comply with the employee responsibilities therein described. I further acknowledge that non- non-compliance with the terms of the policy on Telework may cause the termination of my employee Telework benefits and may lead to disciplinary action. Employee Signature Date Employee Supervisor Signature Date Department Head Signature Date Xxxx/Vice President Date (if applicable) Date Executive Director, HRS Date (if applicable) Date APPENDIX D‌‌ UMB Telework Program - Offsite Workplace Self- Certification Checklist NameResources: SchoolHuman Resource Services Employee/Office: Offsite Work Address: Offsite Work Phone: Supervisor: This checklist is designed to assess the overall safety of your remote workplace and to ensure that you have been properly prepared for Telework. Upon completionLabor Relations 000 X. Xxxxxxxxx Xxxxxx, you should sign and return this form to your supervisor. Describe the workspace in your remote workplace:Xxxxx Xxxxx 000-000-0000

School of Social Work. SSW Office of the Xxxx; Research & Development SSW General Instruction; Field Instruction; SWCOS; Continuing Education SSW Welfare & Child Support SSW Xxxx X. Xxxxx Center for F&C SSW The Institute I & I University Operations UO HRS Office of the VP; UO University Operations; Government & Community Affairs UO HRS UO Public Safety Employee Name:‌‌ APPENDIX Appendix C TELEWORK REQUEST AND CERTIFICATION FORM Employee Name: Job Classification and Department: Telework Day(s) Requested: Work Hours Requested (if different from hours in customary workplace): Requested effective date: Has the completed Offsite Workplace Check List been submitted?: What are the specific tasks/duties to be performed by the employee when Teleworking? Policy Acknowledgement and Teleworker Responsibilities: I acknowledge that I have read Article 20 of the MOU on Telework as negotiated between AFSCME and the UMB and that I understand and will comply with the employee responsibilities therein described. I further acknowledge that non- non-compliance with the terms of the policy on Telework may cause the termination of my employee Telework benefits and may lead to disciplinary action. Employee Signature Date Employee Supervisor Signature Date Department Head Signature Date Xxxx/Vice President Date (if applicable) Date Executive Director, HRS Date (if applicable) Date APPENDIX D‌‌ Appendix D UMB Telework Program - Offsite Workplace Self- Certification Checklist Name: School/Office: Offsite Work Address: Offsite Work Phone: Supervisor: This checklist is designed to assess the overall safety of your remote workplace and to ensure that you have been properly prepared for Telework. Upon completion, you should sign and return this form to your supervisor. Describe the workspace in your remote workplace: