Lamar State College Port Arthur
Flexible Work Arrangement
I.
Short-term Work Arrangement – Related to COVID-19 – (If you are NOT telecommuting, skip to #4.)
1.
This is an agreement between (“the department”) and (“Employee”) to
establish the terms and conditions for performing work at an alternate work site.
2.
This agreement will begin on and continue until notified by department head. The following conditions
apply:
a.
Employee’s telecommuting hours are ____________________.
b.
Employee’s regular location (campus) hours are _____________.
c.
Employee’s contact phone number is .
3.
While telecommuting, Employee will:
a.
remain accessible by phone or electronically during the telecommute work schedule;
b.
be responsible for establishing effective communication among co-workers and customers and to check in
with the supervisor to discuss status and open issues;
c.
be available for teleconferences, scheduled on an as-needed basis;
d.
request supervisor approval in advance of working any overtime hours (if employee is non-exempt);
4.
(check this if applicable) I am unable to telecommute. As a result, I am requesting accommodations to my
work schedule due to the impact of COVID-19 on my department and my personal work schedule. I am requesting
emergency leave for any impact to my work schedule.
a.
Employee’s limited on site (campus) hours are ___________________.
II.
Safety & Equipment; Information Security
1.
Employee agrees to maintain an adequate, safe, and secure work environment and to report work-related injuries
to Employee’s supervisor at the earliest reasonable opportunity. Employee agrees to hold the College harmless for
injury to others at the alternate work site.
2.
Regarding space and equipment purchase, set-up, and maintenance for telecommuting purposes:
a.
Employee is responsible for providing space, telephone, printing, networking and/or Internet capabilities at
the telecommute location, and shall not be reimbursed by the employer for these or related expenses.
Internet access must be via DSL, Cable Modem, or an equivalent bandwidth network.
b.
Employee agrees to protect College-owned equipment, records, and materials from unauthorized or
accidental access, use, modification, destruction, or disclosure.
c.
Employee understands that all equipment, records, and materials provided by the College shall remain
the property of the College and that all software licensing and copyright laws, as well as precautions will be
followed.
d.
No Protected Health Information or otherwise confidential information should be kept on personal
electronic equipment.
I hereby affirm by my signature that I have read this agreement and understand and
agree to all of its provisions.
Employee’s Name
_
Date
_
Supervisor’s Name Date
Retain a copy of this form in your departmental files and forward a copy to Human Resources.
