HomeMy WebLinkAboutPersonnel Action Request Recommendation - Public WorksPERSONNEL ACTION REQUEST (PAR)
Section t - Core Employee Data (Current Data Required)
Empl#: o617
Legal Name: Dart, Samuel P.
I Effective Date: 02/05/20
Section 2 - Employee Data (Required for New Hires, Separations, or if Changing)
Item
Current Data
New Data
Name OLegal
O Preferred
<Enter>
Address
<Enter>
Telephone
(000) 000-0000 ext.
( ) - ext.
SS# - Birthdate
000-oo-0000 — 00/00/00
000-00-0000 — 00/00/00
Section 3 - Requested Action
Action(s)
Leave Data
Separation Data
^
^
^
Start Date oo/oo/oo
Stop Date oo/00/00
Type
^
Reason
^
Eligiblefor Rehire ^
Provide Details of Separation Below
Section 4 - Comments
Interim assignment until ongoing replacement has been recruited and hired.
a) New Wage effective 02/05/20
b) Interim responsibilities effective 03/01/20
Section 5 - Core Items (Current Data Required)
Item
Current Data
New Data
Dept#-Dept
A Public Works-101070
^ ^
Job#-Job Title
189-18-Associate Engineer
000-00-Interim Public Works Director
Hire — Position
10/12/15- 10/12/15
00/00/00 - 00/00/00
Grp#-Name
Nos-Non-Exempt
^
Employee Type
Full Time Regular
^
Section 6 - Secondary Items (Required only if Changing)
Item
Current Data
New Data
Base Wage
$37.07 Hourly
$50.31 Hourly
Band / Step
14/6
23/01
Stipend
$oo.0000 <Select Type>
$oo.0000 <Select Type>
Pay Type/FLSA
Non-Exempt — Salaried (SALYNE)
^
FTE
1.0 (4o hrs/wk)
^
FTE—GrIS Only
<Enter>
<Enter>
Workweek
Standard Sun-Sat
^
Section'7 - Authorizing Signatures
Department: JDate:
Human Resources: VL,-� V
Date: a � � U
Board Approval Re Not qred
Chair: i
Vice-Chair: Date: zj
Member: -
Revised 09/23/19