The following constitutes a work agreement between:

NAME:
AGENCY:
ALTERNATE WORKSITE ADDRESS:
CITY/STATE:
BUSINESS TELEPHONE:
E-MAIL
FAX NO.
SUPERVISOR:

on the terms and conditions of the individual's participation in the attached Flexible Workplace Program.
The employee volunteers to participate in Flexiplace and agrees to adhere to the terms and conditions of the Flexible Workplace Program and this agreement. The Agency concurs with this employee's participation and agrees to adhere to the terms and conditions of the Flexible Workplace Program.

The employee's Flexiplace arrangement will begin on .
The employee chooses chooses not to participate in the office's flexitime plan.
If the employee chooses not to participate in flexitime, the employee and supervisor agree that the employee's official tour of duty will be from to .
If the employee chooses to participate in the office's flexitime plan, the employee will communicate his/her daily start and stop times by means of .

Everything in this section is subject to office coverage needs as outlined in Section 4 of Article 10 and Article 4 of the DOL - Local 12 Collective Bargaining Agreement.

The employee will report to the office on the following day(s) . Nothing precludes the employee and supervisor from informally agreeing that the employee will report to the office on a different day on an ad hoc/as needed basis.

The rules and policies governing the employee's time, attendance, and the requesting of overtime and leave are unchanged by participation in the Flexiplace program. Employees must obtain supervisory approval before taking leave in accordance with prescribed office procedures and applicable law, rule, or regulation. All overtime must be approved in advance by Management. If the employee works overtime that has been directed and/or approved in advance, the employee will be compensated in accordance with applicable law, rule, or regulation.

If the employee uses government equipment, the employee will use and protect the government equipment in accordance with the procedures established in the Federal Information Resources Management Regulation (FIRMR). Government-owned equipment will be serviced and maintained by the Government. If the employee provides his/her own equipment, the employee is responsible for servicing and maintaining it.

Provided the employee is given at least 24 hours advance notice, and Management has reasonable cause to believe that hazardous working conditions exist, an inspection by the Government of the employee's home work site may be conducted during the employee's normal working hours to ensure proper maintenance of Government-owned property and work site conformance with health and safety standards.

Employees must make a reasonable attempt to ensure a safe and healthy work environment.
The Government will not be liable for damages to an employee's personal or real property during the course of performance of official duties or while using government equipment in the employee's residence, except to the extent the Government is held liable by Federal Tort Claims Act claims or claims arising under the Military Personnel and Civilian Employees Claim Act.

The Government will not be responsible for operating costs, home maintenance, or any other incidental cost whatsoever (e.g., utilities) associated with the use of the employee's residence. By participating in this program, the employee does not relinquish any entitlement to reimbursement for authorized expenses incurred while conducting business for the Government, as provided for by statute and implementing regulations.

Injuries that arise in the performance of duty at the alternate worksite are subject to the Federal Employees' Compensation Act.

The employee will apply approved safeguards to protect Government/Agency records from unauthorized disclosure or damage and will comply with Privacy Act requirements set forth in the Privacy Act of 1974, Public Law 93-579, codified at Section 552a, title 5 U.S.C. and specific Agency(ies) confidentiality requirements. The supervisor and employee will discuss these safeguards.

The employee has been provided a copy of the Flexiplace Article.

Employee Signature: ________________________________
Date:________________

Immediate Supervisor's Signature______________________
Date:________________