CERTIFICATE OF RECEIPT. I have been given a copy of “Xxxxx County Public Service Authority / Xxxxx County Acceptable Use Policy”, dated December 1, 2021, entitled “Technology Use Agreement” and I understand that it is my responsibility to read and abide by this policy. If I have any questions about the policy, I understand that I need to ask my supervisor or the Human Resource Officer for clarification. If I refuse to sign this certificate of receipt, my supervisor will be asked to initial this form indicating that a copy has been given to me and that this statement has been read to me. Any person refusing to accept this policy will be denied access to any HCPSA/HC technology systems, including but not limited to: computers, networks, email, and telephone systems. Preferred Name: (print) Department: Signature: Date: For Technology Staff Use Only:
CERTIFICATE OF RECEIPT. Each employer shall ensure that each driver is required to sign a statement certifying that he or she has received a copy of these materials described in this section. Each employer shall maintain the signed certificate and may provide a copy of the certificate to the driver. A copy of the Brown County FMCSA Drug and Alcohol Testing for Commercial Drivers Policy can be obtained from the Human Resources Department.
CERTIFICATE OF RECEIPT. The DPM must require each covered employee to sign a statement certifying receipt of the copy of this policy. The original of the signed statement must be retained by the department, and copy may be provided to the employee.
CERTIFICATE OF RECEIPT. Each covered employee will be required to sign a certificate of receipt certifying that they have not only received a copy of this policy but understands the policy. Questions Regarding This Policy The following City representatives are available to answer questions regarding the information contained in this policy: Human Resources Director or City Attorney
CERTIFICATE OF RECEIPT. Each covered employee will be required to sign a certificate of receipt certifying that they have not only received a copy of this policy but understands the policy, which is the basis for implementing the requirements of the U.S. Department of Transportation Federal Motor Carrier Safety Administration rules and regulations pertaining to alcohol and controlled substances testing of covered employees. Questions Regarding This Policy The following City representatives are available to answer questions regarding the information contained in this policy: Human Resources Director City Attorney EXHIBIT A – To Testing Policy SAFETY-SENSITIVE POSITIONS Safety Sensitive Under FMCSA Authority/Commercial Driver’s License Operations Maintenance Technician Park Maintenance Technician I Park Maintenance Technician II Utility Technician I Utility Technician II Utility Technician III Fleet Services Technician I Fleet Services Technician II Facilities Maintenance Technician I Facilities Maintenance Technician II Parks Maintenance Division Manager Water Division Manager Street/Sewer/Storm Division Manager Maintenance Services Manager Other Safety Sensitive Positions: (not subject to random testing) Property Evidence Technician Police Services Supervisor Community Service Officer
CERTIFICATE OF RECEIPT. The FMCSA and FTA regulations require that each employee sign a statement certifying that he or she has received a copy of this policy. Note: The Certificate of Receipt must be placed in a Driver’s Qualification file and/or the individual’s personnel file.
CERTIFICATE OF RECEIPT. Upon and subject to completion of the delivery of the Product for each shipment, the Buyer shall issue a certificate of receipt to the Seller.
