Article XX: Acknowledgement Of Receipt Of City Of Cole Camp Employee Handbook

[Ord. No. 545, 3-16-2023]

Handbook.

I acknowledge that I have received a copy of the CITY OF COLE CAMP Employee Handbook ("Handbook"). I understand that I am responsible for reading and abiding by all policies and procedures in this Handbook, as well as other policies and procedures of the City.
I also understand that the purpose of this Handbook is to inform me of the City's policies and procedures, and it is not a contract of employment. Nothing in this Handbook provides any entitlement to me or to any City employee. I also understand that the City and/or Board of Aldermen has the right to change any provision of this Handbook at any time and that I will be bound by any such changes.
_______________________ Signature	_____________ Date
______________________________ Please print your full name
Please sign and date one copy of this notice and return it to the City Clerk. Retain a second copy for your reference.

Drug Policy.

CITY OF COLE CAMP ACKNOWLEDGEMENT OF RECEIPT OF DRUG POLICY
I affirm that I have read and understand the City of Cole Camp's Substance Abuse Policy and I understand that I may be subject to discipline, including termination for violating this policy or any other disciplinary policies or work rules of the City. I agree to fully comply with and abide by all rules and regulations set forth in the Substance Abuse Policy as a condition of continued employment by the City.
I further understand that the City has the right to request, in accordance with its Substance Abuse Policy, that I submit to a drug and alcohol screen as a condition of continued employment with the City. I understand that refusal to consent to such a drug and alcohol screen will be considered by the City as insubordination and will result in an employee's termination. I also understand that any attempt to tamper with, adulterate, or substitute the test sample in a drug and alcohol screen will result in an employee's termination.
________________________ Employee Name (Printed)
_______________________ Employee	_____________ Date

Alcohol And Drug Testing Consent.

CITY OF COLE CAMP
CONSENT FORM FOR ALCOHOL AND DRUG TESTING
I, __________, consent to the collection of blood, urine, saliva, hair or breath samples from me and to conduct other medical tests to determine the presence or use of alcohol, drugs or controlled substances. I understand that refusal to consent to such a drug and alcohol screen will be considered by the City as insubordination and may result in an employee's termination. I further understand that any attempt to adulterate the test sample will be considered by the City as insubordination and may result in an employee's termination. I realize that a positive result for the presence of either drugs or alcohol, or both, in any specimen of mine may lead to discipline, up to and including termination. I further certify that I have read and understand City of Cole Camp's Substance Abuse Policy and my right to appeal.
I hereby authorize the laboratory or facility conducting this test to release the results of the test to the City and release the City, any doctor, medical personnel, laboratory and testing facility from any and all liability arising from the release or use of this information.
1) AGREED TO:
_______________________ Employee Name (Printed)
_______________________ Employee's Signature	____________________ Date

Receipt Of Keys.

CITY OF COLE CAMP ACKNOWLEDGEMENT OF RECEIPT OF KEYS
I affirm that I have received _____ key(s) to City Hall and _____ key(s) to the patrol cars and I understand that I may be subject to discipline, including termination for losing, copying without permission, or not maintaining possession of my key(s) at all times. I agree to be responsible for the key(s) I have been given and will immediately report to my immediate supervisor and the City Clerk if at any time my key(s) has been compromised or lost.
I further understand that I may be responsible for reimbursing the City for any and all costs associated with having locks changed in the event that my key(s) is lost or compromised.
I further understand that it is my responsibility to ensure that all City property is securely locked when not in use and if I leave City property unlocked and/or unsecured I will be subject to discipline, up to and including termination.
_______________________ Employee Name (Printed)
_______________________ Employee	____________________ Date
(A copy of the Employee Acknowledgement is to be signed and placed in the employee's personnel file.)

Grivance Form.

CITY OF COLE CAMP GRIEVANCE FORM

Before submitting this Grievance Form, be sure the following is completed.

Claimant: _________________________ Date: __________

Supervisor: ________________________Department: __________

Did you first discuss your grievance with your immediate Supervisor? Yes _____ No _____

Was your Supervisor able to resolve your grievance? Yes _____ No _____

Complete the following:

What was the date of the incident? __________

Explain the incident in detail:

If more space is needed, use additional sheets of paper. Be sure to number the sheets accordingly.

To be completed by the City Clerk's office:

Date of receipt by claimant: ____________________

Appeal Form.

CITY OF COLE CAMP REQUEST FOR APPEAL HEARING

Before submitting this Request for Appeal Form, be sure the following is completed.

Claimant: ______________________ Date: __________

Supervisor: ____________________ Department: __________

Were you suspended __________ or dismissed __________

Complete the following:

What was the date of suspension or dismissal? __________

Explain the incident in detail:

If more space is needed, use additional sheets of paper. Be sure to number the sheets accordingly.

To be completed by the City Clerk's office:

Date of receipt by claimant: _____________________

Date of response to claimant: ____________________

Date of Appeal Hearing: ________________________

Receipt Of Property.

CITY OF COLE CAMP ACKNOWLEDGEMENT OF RECEIPT OF CITY PROPERTY
I affirm that I have received the following equipment listed below and I understand that I may be subject to discipline, including termination for losing or not maintaining possession of the equipment at all times. I agree to be responsible for the equipment I have been given and will immediately report to my immediate supervisor and the City Clerk if at any time my equipment has been compromised or lost.
I further understand that I may be responsible for reimbursing the City for any and all costs associated with having the equipment replaced if it is lost or compromised due to my own actions that are not job related.
I further understand that it is my responsibility to ensure that all City property is securely locked when not in use and if I leave City property unlocked and/or unsecured I will be subject to discipline, up to and including termination.
Property Received:





_______________________ Employee Name (Printed)
____________________ Employee	____________________