The following constitutes an agreement between [variable: Covered Organization] ("Employer") and [variable: Employee Name] ("Employee").

Employee agrees to participate in the [variable: Organization name] telecommuting program and to adhere to applicable guidelines and policies. Employer concurs with employee's participation and agrees to adhere to applicable guidelines and policies.

Terms and Conditions

Duration

This agreement will be valid for a period of [variable: Term] beginning on [variable: Start Date] and ending on [variable: End Date]. At the end of the defined terms term, both parties will participate in a review which may result in the reactivation or suspension of the telecommuting agreement and arrangement.

Work hours

Employee's work hours and work location are specified in Appendix A of this agreement.

Pay and attendance

All pay, leave and travel entitlement will be based on Employee's telecommuting location. Employee's time and attendance will be recorded as performing official duties at the primary business location.

Leave

Employee must obtain approval before taking leave in accordance with established office procedures. By signing this form, Employee agrees to follow established procedures for requesting and obtaining approval of leave.

Overtime

Employee will continue to work in pay status while working at the home office. Overtime work that has been approved in advance will be compensated in accordance with applicable law and Employer policies. Employee understands that Employer will not accept the results of unapproved overtime work and will act vigorously to discourage it.

By signing this agreement, Employee agrees that failing to obtain proper approval for overtime work may result in suspension of the telecommuting program or other appropriate action.

Business-owned equipment

In order to effectively perform their assigned tasks, Employee may use Employer equipment at the telecommuting location with the approval of Employer. The equipment must be protected against damage and unauthorized use. Employer-owned equipment will be serviced and maintained by Employer. Any equipment provided by Employee will be at no cost to Employer, and will be maintained by Employee.

Inspection

Employer reserves the right to periodically inspect Employee's telecommuting location in order to ensure proper maintenance of Employer equipment, adherence to corporate policies, and compliance with physical and information security standards. Employer will notify Employee at least 24 hours in advance of any inspection, which must occur during normal working hours.

Liability

Employer is not be liable for any damages to Employees' property that may result from participation in the telecommuting program.

Reimbursement

Employer is not be responsible for operating costs, home maintenance, or other incidental costs (e.g., utilities) whatsoever, associated with the use of the telecommuting location. Employee does not relinquish any entitlement to standard reimbursement for authorized expenses incurred while conducting business for Employer.

Workers' Compensation

Employee is covered under the Workers' Compensation Law if injured in the course of performing official duties at the telecommuting location.

Work assignments

Employee will communicate with Employer's representative [variable: Designate Employer Contact Person] to receive assignments and to review completed work as necessary or appropriate. Employee will complete all assigned work according to work procedures mutually agreed upon by Employee and Employer's representative, according to guidelines and standards stated in Employee's performance plan.

Employee evaluation

Evaluation of Employee's job performance will be based on norms or other criteria derived from past performance and occupational standards consistent with these guidelines. For assignments without precedent or without standards, regular and required progress reporting by Employee will be used to rate job performance and establish standards. Employee's most recent performance appraisal must indicate fully achieved standards.

Records

Employee will apply approved safeguards to protect Employer data and records from unauthorized disclosure, loss, and damage. Work done at the telecommuting location is considered Employer business. All records, papers, computer files, and correspondence must be safeguarded for their return to the primary business location.

Curtailment of the agreement

[Variable: Specify whether the employee may continue working for your business if the employee no longer wishes to telecommute. Also specify the circumstances under which the telecommuting agreement may be terminated by the business (e.g., if continued participation fails to satisfy business needs) and the consequences of that termination on the worker's continued employment.]

Performance location

Employee agrees to limit performance of assigned duties to the primary business location or to the approved telecommuting location. Failure to comply with this provision may result in termination of the telecommuting agreement and/or other disciplinary actions.

Employee: _ Date: _ Employer Representative: Date: _

Appendix A: Telecommuting Hours and Locations

The following hours and locations are agreed to in support of the Telecommuting Agreement.

Primary Business Location: [variable: Primary business location of employer]

Primary Telecommuting Location: [variable: Primary business location of employee]

Comments (schedule flexibility, etc.):

Signatures:

Employer Representative:  ______________________________________________________

Date: ______________________________________________________

Signature: ______________________________________________________

Company: ______________________________________________________

Address: ______________________________________________________

City: ______________________________________________________

State: ______________________________________________________

Zip: ______________________________________________________

Employee: ______________________________________________________

Date: ______________________________________________________

Signature: ______________________________________________________

Address: ______________________________________________________

City: ______________________________________________________

State: ______________________________________________________

Zip: ______________________________________________________