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<br /> <br />122 <br />221698v1 <br /> <br />Flexible Work Agreement <br /> <br /> <br />Period: Start Date: End Date: _ <br /> <br />Schedule: In the chart below list the hours each day for telework or flexible work. <br /> <br />Pay <br />period <br />Week <br />Day Telework Schedule Flexible Work/ <br />Compressed Work <br />Schedule <br />Additional Details <br />1 Monday <br />Tuesday <br />Wednesday <br />Thursday <br />Friday <br />Saturday <br />Sunday <br />2 Monday <br />Tuesday <br />Wednesday <br />Thursday <br />Friday <br />Saturday <br />Sunday <br /> <br />I have reviewed the Flexible Work Arrangement Policy and agree to abide to the terms and <br />conditions set forth by the policy. <br /> <br /> <br /> <br /> <br />Date Employee <br /> <br /> <br />I have reviewed the above information with _____________________________ prior to their <br />participation in the City's Flexible Work Arrangement Policy. <br /> <br /> <br /> <br />Date Department Head <br /> <br />