HomeMy WebLinkAboutF16.0 Cellular Telephones Attachment D Attachment: D— Section: F / 16.0
:CRAP V N E,
"I' E Y A Sd
11-V
CITY OF GRAPEVINE CELLULAR APPLICATION FORM
City/Employee Share Agreement on City-Supplied Cellular Phones
Date:
Employee Name (Print): Department:
Supervisor:
Employee Number # Cellular Telephone #
The City of Grapevine, Texas, recognizing I.R.S. guidelines for employees' benefits
requires a shared cost for cellular services. Employees whose supervisor approves the
necessity of a City-supplied cellular phone to perform their job must choose between
one of the following two reimbursement plans:
Please Designate Selected Choice:
Plan # 1- Employee pays 25% of base monthly cellular plan. Employee
payments will be made by regular payroll deduction. In addition, if the employee
exceeds their base plan of minutes any month, they will reimburse the City for all
incoming and outgoing personal calls above their allowed plan minutes limit at the
appropriate rate of $
Bi-Weekly payroll deduction $
Plan # 2- Employee pays the appropriate plan rate per minutes of $
for all personal (incoming and outgoing) calls.
Employees are responsible monthly to review their cellular bills and pay all personal
charges due to the Finance Department at City Hall.
Notes:These two plans pertain to City-assigned cellular phones only. Departments
may designate some employees to utilize pooled cellular phones at no shared cost to
1 of 2 Revised: 02/01/2014
CITY OF GRAPEVINE CELLULAR APPLICATION FORM
them. Employees must, however, reimburse the City for personal calls.
Blackberry and PDA connections, and Enterprise paging, are City-business (need)
mandated. Therefore, these features are not subject to employee shared payment.
Limited text messaging is also available for business use.
Supervisors are responsible to see that their department's cellular bills are periodically
reviewed for compliance.
As a participant of this program, I understand and agree to the following terms and
conditions:
1. I acknowledge that I have received a copy of and understand the City's cellular
equipment policy.
2. Commitment period: Employees must be on a cost plan at least six months
before changing the choice of plan.
3. Modifications require completion of a new City/employee share agreement
form.
4. Cancellation: The employee's supervisor must approve and document any
cancellation of this agreement and forward to Finance.
5. Plan 1: If minute limits on the employee's choice of base plan are routinely
exceeded, then the employee's % cost share can be increased with the
approval of their supervisor.
Supervisor Approval:
Date:
Requesting Cancellation of this Agreement:
Employee:
Supervisor:
Date:
2 of 2 Revised: 02/01/2014