HomeMy WebLinkAboutPersonnel Action Request - Public WorksPERSONNEL TI T (PAR)
Section t — Core Employee Data (Current Data Required)
Empl#; 0355--
Legal. Name,-, BOOTH, ANDREW L.
Effective. Date: 01/01 /22
Section 2 — EMployee, Data (Required for New Hires, S!�parations, fir if Changing)
Itein
Current Data
New Data
Name ref
0 ED PL e ga eI rest
AndreNNT L. Booth
<Enter>
Address
Telephone I
ext*
SS# Birthdate 000-00-0000 — 00/00/00
SectiOn. 3 — Requested Action
Action(s)
Leave Data SeParation Data
Other (Provide Comments)
A Type Reason
A A,
Start Date oo/oo/oo
pbA
Stop Date 00/o.o/oo Eligilefor Rehl"I-e.
Provide Details.Qtz Below
Qfftal' '0 n
SectiO n- 4 — Comments
Provide a $.rwo.00 per month stipend for obtainiong and maintaining bridge inspectors certitic.ti ons.
Se. �t�ion 5 Core Items (Curre At Data Required)
Item
Current .data New Data.
Dept -dept
Public Works-io�o6o A A
Job# -Job Title,
.18924-Brlidge Supem,'sor
Hire — Position
09/24/01 - o8/25/14
Grp#-Nc,im,e
No3-Manager-Super.sor A
-Employee Type
Full Time Regular A
Section 6 — Secondary Items (Redi mil y if, Changing),,,__
hent
CurrentData
Netv Data
Base Wage$
<Select Cycle>
t <Select Cycle>
Band. / Step
Stipend
$oo.0000 <Select Type>
$2oo,0000 Other
Pay Type/FLSA
Exempt (SALRYE)
A
FTE
1.0 (4o hrs/wk)
A
FTE—GrIS Only
<Enter>
<Enter>
Workweek.
Standard Sun -Sat
A
Auth i i
pee tiow OrIzIng. Signatures,
Department: Date: -7/11
Human Resources.- Date:
Board Approval 21- Required Not Required.
Chair,*,, 9 e7
Vice -Chair: Date:
Member: IN,
Revised 0 TI 0/ 19