ContractTelecommute Agreement • February 11th, 2004
Contract Type FiledFebruary 11th, 2004The Resources Agency State of CaliforniaDEPARTMENT OF FISH AND WILDLIFEClear Form TELECOMMUTE AGREEMENT Print Form NAME ORGANIZATION CLASSIFICATION POSITION NUMBER BARGAINING UNIT OFFICE PHONE NUMBER TYPE OF REQUEST (Check One):The employee will telecommute On a weekly basis as follows: On a monthly basis as follows: Telecommuting Work Hours: First time Request day(s) per week (telecommuting days) to Revision month DESIGNATED DFW WORK LOCATION Phone No. HOME OFFICE LOCATION Phone No. WORK PLANAttach a list of specific work assignments with expected dates of completion. This list will be renewed. weekly monthly quarterly other EQUIPMENT EXPENSESList DFW-owned equipment and software, such as personal computers, modems, fax machines, bookcases,etc., to be used by the employee at the home office. Indicate the property number if applicable. If theequipment is to be purchased by the DFW, indicate the cost.EQUIPMENT COST