Common use of STATEMENT BY GRIEVANT OR UNION Clause in Contracts

STATEMENT BY GRIEVANT OR UNION. The "statement" should include: (1) nature of the contract violation; i.e., what action did the employer take, or fail to take, which violated the Contract; (2) the date(s) of the violation and, where appropriate as in promotions, demotions, transfers, reassignments, etc., the relevant title(s) and work location(s). (Use additional sheets of paper, if necessary.) RELIEF OR REMEDY SOUGHT Grievant's Signature Date Xxxxxxx/Union Representative Signature Date In accordance with Articles 22 and 23, all disciplinary grievances must also include the following completed form. WAIVER OF RIGHT TO APPEAL DISCIPLINARY ACTION I wish to submit the attached grievance under Article 23, Grievance Procedure and Article 22, Arbitration of Disciplinary Action, appealing my demotion, suspension or discharge effective on and pursuant to Article 22, Section 4 of the Agreement between the NAGE and the Commonwealth of Massachusetts dated I hereby waive any and all rights to appeal this disciplinary action to any other forum including the Civil Service Commission. I have not initiated any other appeal of this disciplinary action. DATE EMPLOYEE SIGNATURE UNION REPRESENTATIVE SIGNATURE APPENDIX C NON-SELECTION FORM EMPLOYEE NAME CURRENT POSITION X.X. ADDRESS TITLE POSITION SOUGHT X.X. TITLE Employee Identification Number: We regret to inform you that another applicant has been selected for the position you sought. That applicant has been selected (because he/she has been deemed to be more qualified than you by virtue of) for one or more of the following reasons:

STATEMENT BY GRIEVANT OR UNION. The '"statement" should include: (1) nature of the contract violation; i.e., what action did the employer Employer take, or fail to take, which violated the Contract; (2) the date(s) of the violation and, where appropriate as in promotions, demotions, transfers, reassignments, etc., the relevant title(s) and work location(s). (Use additional sheets of paper, if necessary.) RELIEF OR REMEDY SOUGHT Grievant's ’s Signature Date Xxxxxxx/Union Representative Date Signature Date In accordance with Articles 22 23 and 2323A, all disciplinary grievances must also include the following completed form. WAIVER CONFIRMATION OF RIGHT TO APPEAL DISCIPLINARY ACTION FORUM I wish to submit the attached grievance under Article 2323A, Grievance Procedure and Article 2223, Arbitration Arbitrations of Disciplinary Action, appealing my demotion, suspension or discharge effective on and pursuant to Article 2223, Section 4 of the Agreement between the NAGE Alliance and the Commonwealth of Massachusetts dated . I hereby waive any and all rights to understand that if I appeal this disciplinary action to any other forum including forum, excluding the Civil Service Labor Relations Commission, my grievance shall be considered withdrawn. I confirm that I have not initiated any other appeal of this disciplinary action. DATE EMPLOYEE SIGNATURE UNION REPRESENTATIVE SIGNATURE APPENDIX C NON-SELECTION G-1 REQUEST FOR MEDICAL VERIFICATION FORM EMPLOYEE NAME CURRENT POSITION X.X. ADDRESS TITLE POSITION SOUGHT X.X. TITLE Employee Identification NumberAGENCY LETTERHEAD Date: We regret Dear : Pursuant to inform the provisions of Article 8 of the Agreement, it is requested that you that another applicant has been selected submit satisfactory medical evidence for your recent time away from work on the following dates (list dates) . Medical verification is being requested because (list reasons) . Failure to produce such medical evidence by (date) may result in denial of sick leave compensation for the position you sought. That applicant has been selected (because he/she has been deemed following dates: In order to be more qualified than you by virtue of) for one or more of considered satisfactory, the following reasonsmedical verification must include:

STATEMENT BY GRIEVANT OR UNION. The '"statement" should include: (1) nature of the contract violation; i.e., what action did the employer Employer take, or fail to take, which violated the Contract; (2) the date(s) of the violation and, where appropriate as in promotions, demotions, transfers, reassignments, etc., the relevant title(s) and work location(s). (Use additional sheets of paper, if necessary.) RELIEF OR REMEDY SOUGHT Grievant's ’s Signature Date Xxxxxxx/Union Representative Date Signature Date In accordance with Articles 22 23 and 2323A, all disciplinary grievances must also include the following completed form. WAIVER CONFIRMATION OF RIGHT TO APPEAL DISCIPLINARY ACTION FORUM I wish to submit the attached grievance under Article 2323A, Grievance Procedure and Article 2223, Arbitration Arbitrations of Disciplinary Action, appealing my demotion, suspension or discharge effective on and pursuant to Article 2223, Section 4 of the Agreement between the NAGE Alliance and the Commonwealth of Massachusetts dated . I hereby waive any and all rights to understand that if I appeal this disciplinary action to any other forum including forum, excluding the Civil Service Labor Relations Commission, my grievance shall be considered withdrawn. I confirm that I have not initiated any other appeal of this disciplinary action. DATE EMPLOYEE SIGNATURE UNION REPRESENTATIVE SIGNATURE APPENDIX C NON-SELECTION G-1 Date: REQUEST FOR MEDICAL VERIFICATION FORM EMPLOYEE NAME CURRENT POSITION X.X. ADDRESS TITLE POSITION SOUGHT X.X. TITLE Employee Identification NumberAGENCY LETTERHEAD Dear : We regret Pursuant to inform the provisions of Article 8 of the Agreement, it is requested that you that another applicant has been selected submit satisfactory medical evidence for your recent time away from work on the following dates (list dates) . Medical verification is being requested because (list reasons) . Failure to produce such medical evidence by (date) may result in denial of sick leave compensation for the position you sought. That applicant has been selected (because he/she has been deemed following dates: In order to be more qualified than you by virtue of) for one or more of considered satisfactory, the following reasonsmedical verification must include:

STATEMENT BY GRIEVANT OR UNION. The "statement" should include: (1) nature of the contract violation; i.e., what action did the employer take, or fail to take, which violated the Contract; (2) the date(s) of the violation and, where appropriate as in promotions, demotions, transfers, reassignments, etc., the relevant title(s) and work location(s). (Use additional sheets of paper, if necessary.) RELIEF OR REMEDY SOUGHT GrievantXxxxxxxx's Signature Date Xxxxxxx/Union Representative Signature Date In accordance with Articles 22 and 23, all disciplinary grievances must also include the following completed form. WAIVER OF RIGHT TO APPEAL DISCIPLINARY ACTION I wish to submit the attached grievance under Article 23, Grievance Procedure and Article 22, Arbitration of Disciplinary Action, appealing my demotion, suspension or discharge effective on and pursuant to Article 22, Section 4 of the Agreement between the NAGE and the Commonwealth of Massachusetts dated I hereby waive any and all rights to appeal this disciplinary action to any other forum including the Civil Service Commission. I have not initiated any other appeal of this disciplinary action. DATE EMPLOYEE SIGNATURE UNION REPRESENTATIVE SIGNATURE APPENDIX C NON-SELECTION FORM EMPLOYEE NAME CURRENT POSITION X.X. ADDRESS TITLE POSITION SOUGHT X.X. TITLE Employee Identification Number: We regret to inform you that another applicant has been selected for the position you sought. That applicant has been selected (because he/she has been deemed to be more qualified than you by virtue of) for one or more of the following reasons:

STATEMENT BY GRIEVANT OR UNION. The '"statement" should include: (1) nature of the contract violation; i.e., what action did the employer Employer take, or fail to take, which violated the Contract; (2) the date(s) of the violation and, where appropriate as in promotions, demotions, transfers, reassignments, etc., the relevant title(s) and work location(s). (Use additional sheets of paper, if necessary.) RELIEF OR REMEDY SOUGHT Grievant's Xxxxxxxx’s Signature Date Xxxxxxx/Union Representative Date Signature Date In accordance with Articles 22 23 and 2323A, all disciplinary grievances must also include the following completed form. WAIVER CONFIRMATION OF RIGHT TO APPEAL DISCIPLINARY ACTION FORUM I wish to submit the attached grievance under Article 2323A, Grievance Procedure and Article 2223, Arbitration Arbitrations of Disciplinary Action, appealing my demotion, suspension or discharge effective on and pursuant to Article 2223, Section 4 of the Agreement between the NAGE Alliance and the Commonwealth of Massachusetts dated . I hereby waive any and all rights to understand that if I appeal this disciplinary action to any other forum including forum, excluding the Civil Service Labor Relations Commission, my grievance shall be considered withdrawn. I confirm that I have not initiated any other appeal of this disciplinary action. DATE EMPLOYEE SIGNATURE UNION REPRESENTATIVE SIGNATURE APPENDIX C NON-SELECTION G-1 REQUEST FOR MEDICAL VERIFICATION FORM EMPLOYEE NAME CURRENT POSITION X.X. ADDRESS TITLE POSITION SOUGHT X.X. TITLE Employee Identification NumberAGENCY LETTERHEAD Date: We regret Dear : Pursuant to inform the provisions of Article 8 of the Agreement, it is requested that you that another applicant has been selected submit satisfactory medical evidence for your recent time away from work on the following dates (list dates) . Medical verification is being requested because (list reasons) . Failure to produce such medical evidence by (date) may result in denial of sick leave compensation for the position you sought. That applicant has been selected (because he/she has been deemed following dates: In order to be more qualified than you by virtue of) for one or more of considered satisfactory, the following reasonsmedical verification must include: