COLLECTIVE BARGAINING
AGREEMENT
Between
CALIFORNIA UNITED HOMECARE WORKERS,
SEIU/AFSCME
LOCAL 4034
and
COMMUNICATIONS WORKERS OF AMERICA,
AFL-CIO, CLC
January 4, 2012 – January 3, 2015
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TABLE OF CONTENTS
PREAMBLE ............................................................................................................................................. 3
ARTICLE 1- UNION SECURITY........................................................................................................... 3
ARTICLE 2- MANAGEMENT RIGHTS................................................................................................ 6
ARTICLE 3- COMPENSATION............................................................................................................. 7
ARTICLE 4- HEALTH & WELFARE BENEFITS .............................................................................. 12
ARTICLE 5- LEAVES OF ABSENCES ............................................................................................... 14
ARTICLE 6- JOB SECURITY .............................................................................................................. 19
ARTICLE 7- EXPENSE REIMBURSEMENTS ................................................................................... 20
ARTICLE 8- CONTRACT SECURITY ................................................................................................ 21
APPENDIX A- WAGE SCALE, AUTO AND SPECIAL TRAVEL ALLOWANCES ....................... 26
APPENDIX B- CWA MEMBER COMMUNICATION ....................................................................... 27
APPENDIX C- MONITORING............................................................................................................. 27
APPENDIX D- PAYROLL DEDUCTION OF DUES AUTHORIZATION ........................................ 28
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PREAMBLE
The following is the Collective Bargaining Agreement between the
COMMUNICATIONS WORKERS OF AMERICA, ALF-CIO, CLC and
CALIFORNIA UNITED HOMECARE WORKERS UNION, SERVICE EMPLOYEES
INTERNATION UNION/ AMERICAN FEDERATION OF STATE, COUNTY AND
MUNICIPAL EMPLOYEES LOCAL 4034. This Agreement is entered into and
between the Communications Workers of America, AFL-CIO, CLC, herein after
referred to as the “Union” or “CWA” and California United Homecare Workers, Service
Employees International Union- American Federation of State, County and Municipal
Employees Local 4034 herein after referred to as the “Employer” or “CUHW.”
It is recognized that CUHW is democratic member driven union dedicated to protecting
the In-Home Support Servicers program, the homecare providers who make this lifeline
program possible, and the hundreds of thousands of California seniors and people living
with disabilities who rely on homecare for their most basic needs. The parties agree that
providing member leaders with opportunities to learn and grow is essential for a
member driven union and that nothing in this agreement is intended to or may limit
member opportunities in any way.
ARTICLE 1
UNION SECURITY
1.1
Recognition
1.1.1
This Agreement is entered into and between the Communications Workers of America,
AFL-CIO, CLC, herein after referred to as the “Union” or “CWA” and California United
Homecare Workers, Service Employees International Union- American Federation of State,
County and Municipal Employees Local 4034 herein after referred to as the “Employer” or
“CUHW.”
1.1.2
On August 23, 2011, the Union demonstrated a majority of support by eligible employees
in the classifications listed below as “Included” who wish to be represented by the Union
for purposes of collective bargaining and workplace representation.
1.1.3
Based on its showing of majority status, the Employer hereby recognizes the Union as the
sole and exclusive bargaining representative of the employees in the following unit:
1.1.4
Included: Administrative Assistant, Communications Coordinator, Field Organizer,
Member Resources Coordinator, Member Organizing Coordinator, Political Coordinator,
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and any and all other eligible employees employed by the Employer at all of its facilities
that is non-management in nature or non-confidential.
1.2
1.3
1.1.5
Excluded: Executive Director, Directors, Supervisors, Executive Administrative Assistant,
confidential employees, and all other employees excluded under the National Labor
Relations Act.
1.1.6
In the event the Employer establishes any new non-supervisory or non-confidential job
classification (s), the Employer will notify CWA for the purpose of meeting and discussing
the rate of pay, job duties, hours and other conditions of employment for the new job
classification(s).
1.1.7
Additions to, or changes in recognition as described in this Article may be made by mutual
agreement between the Union and Employer.
1.1.8
Whenever a person is hired in any job classification (full-time, part-time, or temporary, as
defined in Section 2.1 of Article 1, Temporary Employees) as set forth herein, the
Employer shall notify such person that the Union is the recognized representative for
employees in that classification.
Temporary Employees
1.2.1
Temporary Employees covered by this Agreement are defined as non-permanent employees
who work within a vacancy in a covered classification or work in a covered classification
for a regular staff person who is out on leave, except for CUHW members.
1.2.2
Time accrued as a temporary employee shall not be applied towards vacation accrual and
step progression in the event that the temporary employee is offered a regular permanent
position.
1.2.3
Except when a temporary employee(s) is filling in for a staff person on leave, no temporary
employee will be employed continuously for more than 270 calendar days.
CWA Membership and Dues Check-off
1.3.1
The Employer agrees that all employees covered under this Agreement shall, as a condition
of employment, thirty-one (31) days from the effective date of this Agreement become and
remain members of the CWA in good standing.
1.3.2
The Employer further agrees that all new employees, in classifications covered by this
Agreement, hired subsequent to the effective date of this Agreement shall, as a condition of
employment, thirty-one (31) days from the date of employment become and remain
members of CWA in good standing.
1.3.3
Upon written notice from the CWA that an employee is not in good standing, the Employer
agrees to terminate employment of said employee immediately, unless such action conflicts
with State or Federal law.
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1.4
1.5
1.3.4
Upon submission of a signed dues authorization, in Appendix D, the Employer agrees to
deduct CWA dues from the wages of each employee each pay period. The Employer
agrees to forward such to the Secretary-Treasurer of the CWA monthly.
1.3.5
The Union shall indemnify and hold the Employer harmless against any and all claims,
suits, or other forms of liability that may arise out of the Employer’s compliance with any
of the provisions of this Article.
Access to Records
1.4.1
Upon request, employees have the right to review the contents of their personnel files and
employee payroll records. Employees who wish to review their own file should contact the
Executive Director to schedule a convenient time. Union representatives shall be permitted
to review employee’s records when accompanied by the employee or upon presentation of a
written authorization signed by the employee. The employee or Union representative when
accompanied by the employee or upon presentation of a written authorization signed by the
employee may request a copy of the employee’s personnel record. The Employer may
verify any written authorization. Third party reference material shall not be made available.
1.4.2
The right to review does not apply to: (1) records relating to the investigation of a possible
criminal offense, unless those records were used as the basis for discipline or termination;
(2) letters of reference, reports, ratings or records that (a) were obtained prior to the
employee’s employment, (b) were prepared by identifiable examination committee
members or (c) were obtained in connection with a promotional exam; (3) records relating
to a complaint or report of sexual harassment made against the employee; or (4) other
documents CUHW deems confidential and as permitted by law.
1.4.3
All requests must be presented in writing to the Employer. All requests are good for (10)
working days.
Stewards and Union Representatives
1.5.1
One (1) Steward shall be designated by the CWA. CWA will provide the Employer with
written notification of the designated authorized Steward. The Steward will be granted
reasonable release time, upon approval of their immediate supervisor, to attend joint
meetings with CUHW for the purposes of administrating the contract, including grievance
and investigatory meetings subject to their work responsibilities and will suffer no loss in
wages or seniority for time spent during investigatory, disciplinary or grievance meetings.
In case of a conflict between their work assignments and steward responsibilities, CWA
shall designate an alternate steward.
1.5.2
One bargaining unit employee shall be eligible for three (3) year, unpaid leave of absence if
elected to Union office. Such employees shall provide thirty (30) days advanced written
notice of such a leave, and may return from the leave early only with the permission of the
Employer. The employee returning from a long-term leave shall return to a vacancy in the
same classification at the same rate of pay, in the same home office if a vacancy in that
classification and in that office exists. Should no vacancy exist the employee shall be
eligible for rehire at such time as there is a vacancy.
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1.6
Employer-Union Relations
The Employer and Union recognize that it is in the best interest of both parties that the
relationship between them be characterized by mutual responsibility and respect. It is the
purpose of this Agreement to promote and provide for harmonious relations, cooperation, and
understanding between CUHW and its employees covered by this Agreement; and to enable
CUHW and its employees to provide the highest level of service to the members they serve.
Towards these ends, CUHW and the CWA will promote respectful relations between managers
and the employees covered by this Agreement.
1.7
Labor Management Committee
The parties will establish and maintain a Labor Management committee to discuss and attempt
to resolve work-related concerns of either party.
1.8
Non-Discrimination
Neither the Employer nor the Union shall discriminate against any employee because of race,
color, religion, creed, sex, national origin, sexual orientation, gender identification, union
activity, political affiliation, marital status, age, or disability in accordance with applicable
public law.
ARTICLE 2
MANAGEMENT RIGHTS
2.1
Management Rights
CUHW reserves and retains solely and exclusively all of its same inherent rights to manage its
affairs as it existed prior to the execution of this Agreement with CWA. Without limiting the
generality of the forgoing, the sole and exclusive rights of management which are not limited
by this Agreement include, but are not limited to, these rights: to determine, and from time to
time re-determine, the number and locations of its offices, and the methods, processes, staffing
arrangements, equipment, programs, and materials to be employed; to discontinue the use of
any processes, operations, staffing arrangements, equipment, or programs; to determine the
number of hours per day or week operations shall be carried on; to select and determine the
number, qualifications, and types of employees required; and to assign duties to such
employees.
The CWA acknowledges the unique challenges that result in representing the staff of another
labor organization. It also acknowledges that CUHW has a duty to aggressively represent its
members, and a responsibility to the millions of members of both SEIU and AFSCME to
participate in their collective decisions. In the event of a conflict between their obligations as
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staff of CUHW and decisions of CWA, which may be if direct conflict, the employees of
CUHW are expected to carry out the objectives and priorities of CUHW and SEIU and or
AFSCME as directed by CUHW and SEIU and or AFSCME.
2.2
Dress Code
Employees are expected to dress and groom in accordance with accepted social and business
standards, particularly if the job involves dealing with members, employers or visitors in
person.
ARTICLE 3
COMPENSATION
3.1
Salary
Upon ratification of this agreement, the pay scales in Appendix A will become effective and
implemented on the dates listed in the scale.
3.2
Mileage and Transportation
3.2.1
All CUHW staff are required to have and maintain a driver’s license as a condition of
employment.
3.2.2
For staff without a car allowance, mileage incurred while conducting CUHW business
outside of the normal day-to-day commute to her/his designated office will be reimbursed
at the IRS rate for appropriately substantiated miles.
3.2.3
Employees required to own and operate a motor vehicle, as a condition of employment
shall maintain adequate insurance coverage and a good motor vehicle record to protect the
interest of CUHW against third parties. The minimum level of coverage shall be one
hundred thousand dollars ($100,000) per person and three hundred thousand dollars
($300,000) per accident. Failure to maintain this level of coverage shall constiture grounds
for discipline, including dismissal. The employee will provide proof of insurance coverage
during the months of January, April, July and October.
3.2.4
For staff required to own and operate a motor vehicle as a condition of employment,
CUHW will provide an auto allowance (see Appendix A). This amount is intended to
offset the costs of owning, maintaining and using the vehicle and includes gas. Staff
receiving an auto allowance shall be required to use their vehicles when they participate in
any CUHW activity that requires less than eight (8) hours round trip drive from their
assigned office. Car allowances are a fully taxable benefit. Car allowances are paid in
advance and may be prorated in the event that a bargaining unit employee is discharged or
resigns.
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3.3
3.2.5
Upon ratification of this agreement, the Auto allowances and Travel allowances in
Appendix A will become effective.
3.2.6
CUHW reserves the right to adjust a given allowance should the work duties of a staff
person change in a way that would warrant a different amount. Upon request, CUHW will
meet and discuss any such adjustments with CWA.
3.2.7
CUHW also may provide a lease vehicle in lieu of the auto allowance at the employee’s
request. CUHW reserves the right to provide a leased vehicle to new hires in lieu of an
auto allowance.
3.2.8
CUHW shall provide worksite parking or pay for alternate parking. CUHW shall
reimburse employees for reasonable parking expenses incurred during the course of their
work assignment(s). CUHW shall reimburse employees for non-commute toll expenses
incurred during the course of their work assignment(s).
Hours of Work
3.3.1
The regular workday runs from 9:00 a.m. to 5:30 p.m., Monday to Friday. Exempt
employees may be expected or required to work additional hours during the evenings or on
weekends or holidays. The exempt employee’s salary fully compensates the employee for
all hours worked, including time worked on evenings, weekends, and holidays.
3.3.2
For the purposes of this agreement, exempt employees are those defined as exempt in the
Fair Labor Standards Act and the California Labor Code. All other employees are nonexempt.
3.3.3
Employees who are classified as non-exempt from state or federal overtime requirements
shall receive overtime pay for all hours worked in excess of 8 in a day or 40 in a week. All
overtime must be authorized in advance by the employee’s immediate supervisor or the
Executive Director. CUHW will make reasonable efforts to accommodate employees who
are not available to work an overtime assignment. However, from time to time, nonexempt employees may be required to work overtime.
3.3.4
Overtime for non-exempt employees will be paid at one and one-half (1 1/2) times the
employee’s regular rate of pay for all hours worked over eight (8) hours in any one
workday or over forty (40) hours in a workweek and for the first eight (8) hours on the
seventh consecutive day of work; or two (2) times the employee’s regular rate of pay for all
hours worked over twelve (12) hours in any one workday and all hours worked over eight
(8) on the seventh consecutive day.
3.3.5
If the employee is paid on a salary basis rather than an hourly basis, the employee’s salary
shall be divided by 40 hours, to provide the employee’s regular rate of pay.
3.3.6
The work week for purposes of overtime calculation runs from Sunday to Saturday.
3.3.7
Paid time off for holidays, vacation, or any other form of paid leave will not be counted as
hours worked for the purposes of determining overtime pay for non-exempt employees.
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3.3.8
3.4
3.5
3.6
With the exception of meal breaks, employees working out of one of the CUHW offices
with regular business hours are expected to be at the assigned office no later than that
offices regular business hours and continue working until at least the end of that offices
regular hours unless they are required to perform approved work away from their assigned
office.
Compensatory Time
3.4.1
CUHW reserves the right to provide Compensatory Time Off to staff when the Executive
Director believes it is appropriate.
3.4.2
Request to take compensatory time off shall not be unreasonably denied.
Recovery Time
The parties recognize that the need for recovery time arises for exempt staff as a result of work
efforts to carry out the mission of the union. Recovery time shall not be accumulated for later
use; it should be taken as soon as possible after completion of an assignment which creates the
need.
3.5.1
For every week in which an employee is required in writing to work seven (7) consecutive
days, the employee shall be entitled to take one day off.
3.5.2
For every two (2) weeks in a given calendar month in which an employee is required in
writing to work six (6) days in a calendar week, the employee shall be entitled to take one
day off.
3.5.3
Employees shall be able to take at least three (3) consecutive days off at the end of each
twenty-one (21) day period worked out of their regular area.
Vacation
3.6.1
Subject to the following policy, regular, full-time employees are eligible for paid vacation
benefits in accordance with the following schedule:
LENGTH OF
SERVICE with CUHW
PAID VACATION
ACCRUED MONTHLY
PAID VACATION
ACCRUED
ANNUALLY
0-24 months
0.83 days
ten (10) work days
25-60 months
1 day
twelve (12) work days
61-120 months
1.25 days
fifteen (15) work days
121 or more months
1.5 days
eighteen (18) work days
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3.7
3.6.2
Employees will begin to accrue vacation benefits from their first day of employment.
However, an employee may not take paid vacation until after he or she has completed six
months of employment. Vacation benefits do not accrue during leaves of absence.
3.6.3
CUHW recognizes that working in the labor movement is difficult and demanding work
and that employees need vacation time to recuperate, relax and pursue other interests.
Therefore, employees are encouraged to use all accrued vacation each year. An employee
may carry over no more than 10 days of accrued vacation time from year to year. If an
employee has more than 10 accrued vacation days at the end of the calendar year, CUHW
will pay out the remaining accrued vacation days as wages at employee’s current rate of
pay. Employees who wish to carry over up to 10 days of accrued vacation pay to the
following year must notify the Executive Director in writing no later than December 1 of
the calendar year.
3.6.4
Employees must submit requests to use vacation time to his/her supervisor for scheduling
and approval. The Request for Time-Off form should be used for this purpose. Although
efforts will be made to accommodate employees’ requests to take vacation at a specific
time, supervisors must also consider the needs of CUHW when evaluating vacation
requests. CUHW reserves the right to approve or deny requests for vacation leave based on
the needs of the organization. Vacation requests should be submitted as soon as
practicable, and in no event less than two weeks before the vacation date requested.
3.6.5
Any cash-out of vacation time will be at the sole discretion of the Executive Director.
3.6.6
All accrued but unused vacation will be paid to the employee upon their layoff, termination
or retirement from CUHW, at the employee’s final rate of pay.
Holidays
3.7.1. The following days are recognized as paid holidays:
New Year’s Day
Martin Luther King Jr. Day
President’s Day
Cesar Chavez Day (Observed on the last Monday of March)
Employee’s Birthday (May be scheduled at any time in the calendar year)
Memorial Day
Independence Day
Labor Day
Veterans Day
Thanksgiving Day
Day after Thanksgiving
Last day worked before Christmas
Christmas Day
New Year’s Eve
3.7.2. Regular, full-time employees are eligible for paid holidays upon date of hire. Holiday pay
will be calculated based on the employee's straight-time pay rate
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3.8
3.9
3.7.3
A recognized holiday that falls on a Saturday will be observed on the preceding Friday. A
recognized holiday that falls on a Sunday will be observed on the following Monday.
3.7.4
If a recognized holiday falls during an eligible employee's paid absence (such as vacation or
sick leave), holiday pay will be provided for the holiday instead of the paid time-off benefit
that would otherwise have applied.
3.7.5
If a recognized holiday occurs while an employee is on any form of approved but unpaid
leave of absence, the employee will not be paid for that holiday.
3.7.6
Non-exempt employees will receive pay at overtime rates when they are required to work
on a recognized holiday. To work on a recognized holiday, such an employee must obtain
advance authorization from the Executive Director or the employee’s direct supervisor.
3.7.7
CUHW will make a reasonable effort when workflow allows, to accommodate staff that
wish to observe religious or culturally significant holidays. CUHW will allow the
Employee to use vacation days for these observances.
3.7.8
When work assignments require that an employee work on a scheduled holiday, the
employee shall arrange with the immediate supervisor to take an alternative day off within
thirty (30) calendar days.
Pro-Rata Benefits
3.8.1
In the event the Employer sets a part-time schedule all benefits and wages, excluding
medical, dental and visions may be calculated on a pro-rata basis. Medical, dental and
vision shall be paid by the Employer based on the same terms as for regular full-time
employees, except as modified below.
3.8.2
In cases where the part-time schedules are implemented as part of an accommodation
request by the employee, the health, dental and vision benefits may also be pro-rated at the
same ratio of the part-time to full-time schedule, and to the extent allowed by law.
3.8.3
For the purpose of making the above calculation a 40 hour workweek shall be used as the
denominator in the calculation.
3.8.4
The above reference to the forty hours is for the pro-rata calculation in this Article only,
and has no other application.
Sick Leave
3.9.1
All regular, full-time employees earn one (1) day of paid sick leave per month, beginning
the first day of the month following the month in which they were hired. Unused sick leave
benefits accumulate from year to year up to a maximum of thirty (30) days of benefits.
3.9.2
Eligible employees may use paid sick leave for an absence due to their own illness or injury
or that of a child, parent, spouse, or domestic partner, or any other family member who
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resides in the employee’s household. Sick leave taken to care for a child, parent, spouse or
domestic partner is not counted toward the attendance policy.
3.9.3
For each day that an employee is unable to report to work due to illness, the employee must
make every effort to directly notify their supervisor before the scheduled start of the work
day. In the event the employee is unable to reach their supervisor, the employee must leave
a message with their supervisor no later than 9:00 a.m.
3.9.4
The employee must submit the Request for Time Off form to receive sick pay. Whenever
possible, the Request for Time Off form should be submitted before the scheduled start of
the work day when the employee is unable to work or as soon as possible thereafter, but in
no event later than the day on which the employee returns to work. In the event of a
scheduled medical appointment, the Request for Time Off form must be submitted at least
three business days before the appointment, or as soon thereafter as practicable.
3.9.5
CUHW will require a doctor’s certificate under any of the following circumstances:
•
•
•
•
If an employee has taken time off for a medical appointment;
If an employee is absent from work and uses sick leave for two (2) consecutive days or
more;
If an employee is absent from work and uses sick leave on any day immediately
preceding or following a vacation or a holiday; or
If an employee demonstrates a pattern of leave abuse.
3.9.6
CUHW reserves the right to require a doctor’s certificate in any other circumstance.
3.9.7
If an employee with accumulated sick leave becomes eligible for state or workers’
compensation disability benefits, sick leave benefits will be used to supplement these
benefits so the employee receives the same amount of money as if he/she was working fulltime. The value of sick leave benefits is based on the employee’s base rate of pay at the
time of absence. The combination of any such disability payments and sick leave benefits
cannot exceed the employee’s net weekly earnings and will continue until the employee’s
sick leave benefits have been exhausted.
3.9.8
Sick leave benefits are intended solely to provide income protection to existing employees
in the event of illness or injury, and may not be used for any other absence. Unused sick
benefits will not be paid to employees upon termination of employment.
ARTICLE 4
HEALTH & WELFARE BENEFITS
All descriptions of health and welfare plans are only for reference; the Employer’s obligation is
defined in the plan’s description or contracts. Coverage shall be limited to eligible employees only in
plans listed in this Article.
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4.1
SEIU Pension Plan
The Employer shall continue to pay into the SEIU Affiliates’ Officers and Employees Pension Fund
for all employees in accordance with the provisions and requirements of that Plan.
4.2
SEIU 401(k) Plan
The Employer shall continue its participation in the SEIU Affliates’ Officers and Employees
Supplemental Retirement Savings 401(k) Plan based on the 5% matching formula for all employees
who are eligible or who become eligible under the plan’s current requirements of that plan. The SEIU
Supplemental Retirement Savings 401(k) Plan will allow all employees to self-contribute up to the
legal limits to the 401(k) plan.
4.3
Health Insurance
The Employer shall continue to provide full subscriber health insurance coverage for each eligible
employee and his/her dependent, spouse/domestic partner, or designated beneficiary to any employee
who elects such coverage. During the term of this Agreement the parties may, by mutual agreement,
modify health care options.
4.4
Opt-Out Cash Out
Employees who receive health insurance through another source may apply to Opt-Out of Employer
provided health care coverage and receive five hundred dollars ($500.00) per month in lieu of medical
coverage through the Employer cash-out provided that: (1) there is no adverse effect to the plan(s)
availability or cost; (2) the conversion from coverage to cash-out and, if later desired, from cash-out
back to coverage, is done at time(s) required by the plan(s); and (3) there is no additional tax or other
financial liabilities to the Employer as a result of this provision. This option, when available, shall be
allocated on a first come, first served basis. Seniority shall rule in the event of limited availability.
Employees must show proof of healthcare coverage to be eligible for the Opt-Out Cash Out option.
4.5
Dental Plan
The Employer shall continue to pay for a dental plan for each eligible employee and his/her dependent,
spouse/domestic partner, or designated beneficiary to any employee who elects such coverage.
4.6
Vision Plan
The Employer will provide a vision plan for eligible employees and their dependents, spouse/domestic
partner or designated beneficiary.
4.7
Life Insurance and LTD Plan
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The Employer will continue to provide a life insurance policy for each eligible employee for the
duration of his/her employment. The coverage shall be in the amount of fifty thousand dollars
($50,000.00). This policy includes coverage for accidental death and dismemberment. Employees
shall have the option to purchase additional coverage at their own expense in accordance with the plan
rules.
ARTICLE 5
LEAVES OF ABSENCES
5.1
Family and Medical Leave
5.1.1
Eligibility: Although the federal Family and Medical Leave Act and the California Family
Rights Act do not apply to employers with fewer than 50 employees, like CUHW, CUHW
voluntarily provides family and medical leave to eligible employees. Unless otherwise
noted below, such leaves of absence are unpaid.
In order to qualify for a leave, an employee must have been employed by CUHW for at
least twelve (12) months and must have worked at least 1250 hours during the twelve (12)
month period immediately before the leave would begin. Vacation and sick leave used
during the twelve-month period does not count toward the 1,250 hour eligibility
requirement.
5.1.2
Permissible Purposes of Family and Medical Leave: An eligible employee may request up
to twelve (12) weeks leave in a twelve (12) month period for the birth of a child; to care for
a newborn, for a child who has been placed with the employee for adoption or foster care;
or to care for a spouse, child or parent who has a serious health condition. An eligible
employee may also request a leave due to the employee’s own serious health condition. If
the employee’s serious health condition is due to pregnancy, the employee may be entitled
to an additional amount of leave. Refer to the Pregnancy Disability Leave policy in this
agreement for more detailed information.
5.1.3
The twelve (12) month period used to measure the twelve (12) week limitation will be
measured from the date an employee begins leave under this policy.
5.1.4
Advance Notice: Employees must give advance notice of their need for a leave whenever
such need is foreseeable. Employees must submit the Request for Time-Off form to their
supervisor. The notice should describe the anticipated date the leave will begin and the
anticipated duration of the leave. Whenever possible, the employee should provide notice
thirty (30) days in advance of an anticipated leave. If the need for a family and medical
leave results from an emergency or is otherwise unforeseeable, the employees must provide
as much advance notice as soon as practicable. In the case of emergency, family leave will
not be denied simply because an employee fails to provide advance notice. However, the
employee should provide notice and medical certification as soon as possible.
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5.1.5
Certification by Health Care Provider: A Medical Certification Form must be provided to
support a request for a leave required due to the serious health condition of the employee or
family member. Failure to provide a satisfactory certification may result in the denial or
postponement of a leave. The certification must be issued by the health care provider of the
individual with the serious health condition. The certification must include the date the
serious health condition commenced (if known), the probable duration of the condition and
a statement that the employee is unable to work or to perform one or more of the essential
job functions due to the serious health condition. If the leave is to care for a family
member, the employee must provide certification of the family member’s serious health
condition, the need for the employee’s involvement in the care and the probable duration of
the absence for care.
5.1.6
Benefits During Leave: An employee who is granted a family and medical leave must
utilize any accrued vacation during the period of leave. If the leave is for the employee’s
own serious health condition, the employee will also be required to utilize any accrued sick
leave during the period of leave. An employee who takes leave in connection with the birth
of a child, adoption or foster care placement or to care for a family member with a serious
health condition has the option to utilize any accrued sick leave. Any portion of a leave that
occurs after all vacation and other paid leave benefits have been exhausted will be without
pay. Any paid leave the employee has available will run concurrently with the period of
family leave. For example, if the employee has 10 days of accrued vacation, and uses
family leave for the birth of a child, the first two weeks of that 12-week leave will be paid,
and the remaining 10 weeks will be unpaid.
5.1.7
Health insurance benefits ordinarily provided by CUHW, and for which the employee is
otherwise eligible, will be continued during the 12-week period of leave. If the employee
fails to pay any required premiums during the period of absence, CUHW may recover the
premium that it paid for maintaining group health coverage if (1) the employee fails to
return from leave or works less than thirty (30) days after returning from leave and (2) the
employee’s failure to return is caused by a reason other than a serious health condition or
other circumstances beyond the employee’s control.
5.1.8
CUHW’s contributions to the Pension Fund will cease during the period of leave. The
employee will not accrue paid sick or vacation benefits during the leave.
5.1.9
Unless otherwise stated, all other benefits will continue during the period of leave.
5.1.10 Reemployment: CUHW will make every effort to restore an employee to the same or an
equivalent position upon his or her return from leave taken in compliance with this policy.
However, as a small employer, CUHW cannot guarantee any employee reemployment in
the same or an equivalent position.
5.1.11 Upon reemployment, employee benefits will be restored at the same levels as provided
when the leave began unless there is a change in benefits affecting the employee’s job
classification during the leave.
5.1.12 An employee who takes a leave because of his/her own serious health condition must
provide a medical certification no later than five business days before his/her return to work
15
verifying that he/she is able to return to work, and stating any work restrictions that may
apply to the employee.
5.1.13 Employees will retain their employee status during the period of a family and medical
leave. Moreover, their absence will not be considered a break in service for purposes of
determining their longevity or seniority. Provided that the employee is reemployed, once
an employee returns from a leave, the employee will be credited with all seniority and
service accrued before the leave of absence commenced.
5.2.14 Early Return from Leave: An employee who wishes to return from an approved leave of
absence earlier than anticipated must provide at least five business days’ advance notice to
the Executive Director of the intended date of return. The Executive Director has the sole
discretion to decide whether to permit an employee to return to work early. In the case of
an early return to work where the employee’s leave was due to his/her own serious health
condition, the employee must provide a medical certification stating that the employee is
cleared to return to work without restrictions.
5.1.15 Extensions of Leave of Absence: In its sole discretion, CUHW may grant a request to
extend an approved medical leave of absence, provided that the employee submits a
statement from his/her physician certifying the need for a continued leave of absence.
Employees must also submit another Request for Time-Off form to their supervisor. An
employee requesting an extension must submit the request at least thirty (30) days in
advance of the expiration of the approved leave or at the earliest date the need can
reasonably be known by the employee.
5.2
Pregnancy Disability Leave
5.2.1
An employee with a disability caused by pregnancy, childbirth or a related medical
condition may receive up to four (4) months of unpaid leave or be transferred to another
position if one is available for which the employee is qualified. This leave does not run
concurrently with Family and Medical Leave. An employee applying for pregnancy
disability leave must submit the Request for Time-Off form to her supervisor.
5.2.2
An employee who is takes pregnancy disability leave must utilize any accrued paid sick
leave during the leave. The employee also has the option to use any accrued vacation time
during the leave.
5.2.3
A Medical Certification Form must be provided to support a request for a leave because of
disability related to pregnancy. Failure to provide a satisfactory certification may result in
the denial or postponement of a leave. The certification must be issued by the health care
provider of the individual with the serious health condition. The certification must include
the date the employee became (or will become) disabled due to pregnancy, the probable
duration of the disability and a statement that, because of the disability, the employee is
unable to work or to perform one or more of the essential job functions of her position
without undue risk to herself, the successful completion of her pregnancy or to other
persons.
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5.3
5.4
5.2.4
Upon completion of pregnancy disability leave, the employee will be returned to the same
position she held before taking the leave, unless (a) the employee would not otherwise have
been employed in the same position at the time reinstatement is requested for legitimate
business reasons; or (b) preserving the employee’s job or duties would substantially
undermine CUHW’s ability to operate safely and efficiently.
5.2.5
Benefits during pregnancy disability leave will be treated the same as when an employee
takes Family and Medical Leave. For more detailed information refer to Article 5.1,
Family and Medical.
Bereavement Leave
5.3.1
Regular, full-time employees will be allowed four (4) days of paid leave in the event of a
death in the employee’s family. For purposes of bereavement leave, the term “family”
includes the employee’s parents, stepparents, foster parents, grandparents, children,
siblings, spouse or domestic partner, spouse or domestic partner’s parents, grandparents or
siblings and any other blood relative living in the employee’s household. Employees shall
be allowed one (1) day of paid bereavement leave in the event of the death of an aunt or
uncle.
5.3.2
Additional paid leave for travel purposes, as measured by the fastest practical mode of
transportation, may be granted in CUHW’s sole discretion.
5.3.3
Employees must submit requests for bereavement leave on the Request for Time-Off form
to their supervisors for approval as soon as practicable, and in no event later than the first
day of absence.
Military Leave
5.4.1
CUHW will grant a military leave of absence to regular, full-time employees who are
absent from work because of service in the U.S. uniformed services in accordance with
applicable state and federal laws. Advance notice of military service is required, unless
military necessity prevents such notice or it is otherwise impossible or unreasonable to
provide advance notice. Requests for a military leave of absence must be submitted on the
Request for Time-Off form by the employee to his/her supervisor. Upon completion of
military service, the employee will be reinstated with full seniority to his/her former
position or to a comparable position if application for reemployment is made within ninety
(90) calendar days of release from the service or hospitalization following such service.
5.4.2
Military leave will be unpaid. However, employees may use accrued paid vacation time.
5.4.3
Continuation of health insurance benefits is available as required by applicable laws based
on the length of the leave and subject to the terms, conditions and limitations of the
applicable plans for which the employee is otherwise eligible.
5.4.4
Benefit accruals, such as vacation, sick leave and other similar benefits will be suspended
during the leave and will resume upon the employee’s return to active employment.
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5.5
5.6
Jury Duty
5.5.1
Employees summoned to jury duty must bring a copy of the summons to their supervisor
when they first receive it. An employee requesting a postponement must still bring a copy
of the summons to his/her supervisor and must tell the supervisor he/she is requesting
postponement. CUHW may, in its discretion, instruct an employee to request
postponement of his/her jury service to avoid business hardship.
5.5.2
The employee must call his/her supervisor each day after being released from jury duty, and
inform the supervisor when the employee was released and when he or she must next report
for jury duty. Employees released before 6:00 p.m. are expected to report to work if
requested by their supervisor. If an employee calls the court and finds he/she is not
required to report for jury duty the following day, he/she must report to work the following
day.
5.5.3
Non-exempt employees must take unpaid leave for jury duty. Exempt employees will
receive their regular pay, less any jury stipend, for the first week they serve on a jury.
Exempt employees must attempt to fulfill their job responsibilities to the extent possible
while performing jury service, including without limitation, maintaining contact with coworkers, taking work home, reporting to work before or after jury duty each day and
performing work on weekends.
5.5.4
After the first week of jury service, CUHW will place exempt employees on leave without
pay status for one week at a time. Exempt employees on leave without pay are not allowed
to perform any work for CUHW.
5.5.5
Employees must submit requests for jury duty leave on the Request for Time-Off form to
their supervisors for approval.
5.5.6
After finishing jury duty, all employees are expected to report to work and bring copies of
the papers they received as proof of their jury service.
Personal Leave
From time to time, in its sole discretion, CUHW may permit an employee to take an unpaid leave of
absence of up to six months. The terms and conditions of any such unpaid leave of absence will be in
writing and cannot be changed except in writing. CUHW may require an employee taking such an
unpaid leave of absence to pay the full costs of his or her health insurance premiums during such leave.
Employees taking an unpaid leave of absence under this policy will not accrue any benefits (such as
sick leave or vacation benefits) during the period of leave.
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ARTICLE 6
JOB SECURITY
6.1
Seniority
Seniority is defined as the length of active service of permanent employees with CUHW, inclusive of
time spent working in CUHW jurisdiction under the prior organizations payroll. Seniority as defined
above will apply to all provisions of this Agreement where the term “seniority” is used, except where
explicitly defined otherwise. If an employee is hired into the bargaining unit from another labor
organization, CUHW reserves the right to hire them with some or all of their seniority intact for
purposes of benefits and accrual. Seniority for the purposes of layoff shall be based on the date of hire
with CUHW.
6.2
Orientation
All new employees will be provided with an orientation to their job and will be assisted as may be
necessary in obtaining all relevant materials needed for their job roles. Employer will provide each
newly hired employee a reasonable time, not less than thirty (30) minutes in length, to meet with
his/her Union Steward for the purpose of orientation to the bargaining unit.
6.3
Evaluations
CUHW may conduct performance appraisals for employees within the probationary period and
periodically thereafter.
6.4
6.5
Layoff
6.4.1
CUHW will provide at least two (2) weeks of notice in the case of a layoff. In its sole
discretion, CUHW may choose to provide laid-off employees with 2 weeks of pay in lieu
of notice.
6.4.2
Employees who are laid off for one calendar year are considered terminated from
employment with CUHW.
Severance and Termination
6.5.1
An employee who is terminated for reasons other than the employee’s misconduct may
receive pay in lieu of notice. An employee who has been employed by CUHW for at least
six months, but no more than two years, will be entitled to one week’s pay in lieu of notice.
An employee who has been employed by CUHW for more than two years will be entitled to
two weeks of pay in lieu of notice.
6.5.2
Employees who are terminated based on misconduct will not receive notice or pay in lieu of
notice.
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ARTICLE 7
EXPENSE REIMBURSEMENTS
CUHW will discuss any changes in its Expense Reimbursement policy with CWA prior to
implementation.
7.1
Business Expenses
Employees shall be compensated for all approved expenses incurred while conducting authorized
employer business. There shall be a uniform procedure for reimbursement of incidental expenses and
advances. CUHW will make its best effort to reimburse authorized expenses within seven (7) working
days of submission. Expenses cannot be reimbursed without the appropriate back up documents
required for a given expense. It is expected that requests for reimbursement will be provided within
thirty (30) days of incurring the expense.
7.2
7.3
7.4
Accommodations
7.2.1
When assignments create the necessity to have staff stay overnight in the field or by any
other directive of the Employer to stay in a hotel, the Employer, whenever possible, will
make the accommodations in advance.
7.2.2
CUHW will make an effort to arrange for accommodations that provide effective work
environments.
7.2.3
In the event of unforeseen circumstances that keep an employee from their home, an
employee may, with approval of their supervisor, purchase the use of a hotel room to be
reimbursed by the Employer so long as a reasonable need is established by the employee
when he/she requests reimbursement.
Car Rental
7.3.1
When work assignments require out-of-area work that employees do not drive their
personal or company cars to, a rental car shall be provided by the Employer in advance.
7.3.2
The rental car shall be adequate for the work required as well as be able to handle the
driving and weather conditions of the area.
Per Diem
7.4.1
When employees are required to work in connection with overnight stays a thirty five ($35)
dollar in State and forty five ($45) out of State per diem shall be provided in advance in
coordination with the work assigned.
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7.4.2
7.5
In such cases that constitute unforeseen or emergency circumstances when staff is assigned
to work before a per diem check is available, CUHW will make every reasonable effort to
provide per diems within seven (7) calendar days following the first day of the assignment.
Equipment
For employees who are assigned to work out of their homes or in offices with no support staff or areas
without office access, the employer will make an effort provide all office equipment and necessary
tools, materials and resources that CUHW feels appropriate to successfully perform his or her job.
7.6
Cell Phones
By virtue of the nature of the work performed by certain employees, it may be necessary to equip
employees with an employer sponsored cell phone. The employer shall be responsible for all costs of
calling-plans, warrantee repairs, and appropriate accessories such as, but not limited to, a homecharger, a car-charger, and a hands-free earpiece. CUHW staff is required to use hands free
communications while driving.
7.7
Fuel Expense
7.7.1
Employees shall not be required to pay fuel or maintenance costs associated with employerowned, leased or rented multi-passenger vehicles. Staff is required to fill a rental car before
returning it to avoid any additional costs to CUHW.
7.7.2
Staff will complete a mileage log when using a CUHW owned or leased vehicle. Mileage
logs must be completed at the time of usage. CUHW will provide a mileage log for each
CUHW owned or leased vehicle.
ARTICLE 8
CONTRACT SECURITY
8.1
Health and Safety
8.1.1
CUHW is committed to the safety and health of all employees and recognized the need to
comply with regulations governing injury and accident prevention and employee safety.
Maintaining a safe work environment; however, requires the continuous cooperation of all
employees.
8.1.2
Health and Safety issues arising out of this Section of the Agreement may be referred to the
Labor Management Committee.
8.1.3
This contract Section in no way supersedes the Safety and Policy and Procedures of
CUHW.
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8.2
8.3
Discipline and Discharge
8.2.1
CUHW maintains the right to discipline or discharge its employees. Discipline shall be for
just cause.
8.2.2
CUHW agrees to the concept of progressive discipline. Employees may request a CWA
Union representative during investigatory and disciplinary meetings. Employees shall be
granted a reasonable amount of time to consult with their Union Steward in conjunction
with such meetings without loss of pay.
8.2.3
Probationary employees shall be at will employees for the duration of their probationary
period.
Grievance Procedure
Definition: A grievance is defined as any dispute concerning the interpretation or application of the
express terms of this contract.
8.3.1
Step 1: Informal Discussion
Grievances shall initially be taken up orally by the employee and the Union Steward or
Union representative with the immediate supervisor or other Employer representative with
the authority to resolve the dispute, in an attempt to settle the matter on an informal basis.
8.3.2
Step 2:
a.
If the grievance is not satisfactorily settled at Step 1, it shall be reduced to writing
by the employee and his/her representative and submitted to the employee’s
director and the personnel department within ten (10) working days of the
occurrence or knowledge thereof, in the event of discipline, demotion or
discharge, within fourteen (14) days of occurrence or knowledge thereof. The
written grievance shall describe the nature of the grievance and shall specify the
remedy requested.
b.
The Director and/or his/her designee and Union Steward and/or Union
representative will meet within fourteen (14) days to attempt to resolve the
grievance. A written response will be made by the Director or his/her designee
within fourteen (14) days of said meeting. Failing satisfactory settlement thereof,
either side shall, within fourteen days of written response, refer such grievance to
the Executive Director or his/her designee.
8.3.3
Step 3:
The Executive Director and/or his/her designee will meet with the Union Steward
and/or Union representative within thirty (30) days to attempt to resolve the grievance.
A written response will be made by Executive Director or his/her designee within
fourteen (14) days of said meeting. Failing satisfactory settlement thereof, the Union
may, within fourteen (14) days, refer such grievance to arbitration as established in Step
5.
8.3.4
Step 4. Mediation (optional)
22
a. If the grievance is not resolved a Step 3, the CWA may, within ten (10) working
days following receipt of CUHW’s response at Step 3, request that the grievance be
submitted to mediation prior to proceeding to arbitration. This step is optional and
requires the concurrence of CUHW and CWA. The fees for mediation shall be
shared equally by CWA and CUHW.
b. A request for mediation must be in writing and must be submitted to the Executive
Director and or his/her designee. After submission of the written request, CUHW
shall attempt to obtain the services of a mediator from the State Mediation and
Conciliation Services.
c. The Mediation procedure shall be informal. The primary effort will be to assist the
parties in settling the grievance. Court reporters shall not be used, the rules of
evidence will not apply, and no record shall be made. The mediator will determine
whether witnesses are necessary. If the grievance is resolved through mediation, the
parties may agree to accept the results of the mediation as binding.
d. If the grievance is not resolved in mediation, the mediator may be requested to
provide an immediate oral opinion as to how the grievance would be decided if it
went to arbitration. Such opinion shall be advisory only. However upon mutual
agreement of the parties, the mediator may be requested to furnish such opinion in
writing, including a brief statement of the reasons for the opinion. Such opinion, as
well as confidential discussions by the parties in mediation, shall not be used during
any subsequent arbitration.
8.3.5
Step 5 Arbitration
a. If the written decision at Step 3 does not settle the grievance is rendered within the
time limits set forth a Step 3 and if mediation, as provided in Step 4, is not
requested; or if mediation is not agreed to; or if mediation does not resolve the
grievance; the aggrieved party may serve upon the other parties designee a request
for arbitration. The request for arbitration must be filed within ten (10) working
days following the date of any of the above qualifying events. Failure of the
aggrieved party to serve such written request within said period shall constitute a
waiver of the grievance.
Arbitration Panel
b. If such written notice is served, the parties agree to use the American Arbitration
Association (AAA) for a panel of arbitrators for consideration. The selection shall
be made by each Party alternately striking form the list until one name remains. The
striking shall occur within ten (10) working days of receipt.
c. Arbitration of a grievance hereunder shall be limited to the formal grievance as
originally filed be the employee to the extent that said grievance has not been
satisfactorily resolved.
d. The fees and expenses of the arbitrator shall be the exclusive responsibility of the
losing party, it being mutually agreed that all other expenses including, but not
23
limited to, fees for witnesses, transcripts, and similar costs incurred during such
arbitration will be borne by the party incurring them.
e. The decision of an arbitrator resulting from any arbitration of a grievance hereunder
shall be final and binding upon the parties.
f. The decision of an arbitrator resulting from any arbitration of grievance hereunder
shall not add to, subtract from, or otherwise modify the terms and conditions of this
contract.
8.3.6
Time Limits
Grievance timelines may be waived or extended by mutual consent. Such waiver or
extension shall be documented in writing.
8.4
CUHW Employee Handbook
All provisions of the CUHW Employee Handbook not specifically addressed in this Agreement remain
in full force and effect.
8.5
Savings Clause
In the event that any provision of this Agreement shall be held to be in violation of any state, federal,
local law or regulation, such determination shall not in any way affect the remaining provisions of this
Agreement.
8.6
No Strike / No Lockout
8.6.1
Interruption of CUHW Functions
During the term of this agreement, or and period of extension, neither the CWA, its
members or any employee covered by this Agreement will call, sanction or participate in
any strike, stoppage of work, picketing, slowdown, sympathy strike or concerted
interruption of any function of CUHW, whether or not the cause was subject to arbitration.
If such action occurs, the CWA will make every reasonable effort to terminate the action.
Nor will the CWA, its members, or any employee engage in a boycott or do leafleting
against CUHW, SEIU or AFSCME at any entity under contract with CUHW. An employee
engaging in such action will not be entitled to any benefit that occurs or accrues during that
time, and will be subject to discharge or other discipline.
8.6.2
Lockouts
During the term of this Agreement, or any period of extension, CUHW will not commence
nor continue a lockout of its employees.
8.6.3
Relief
24
CUHW and the CWA shall have the right to full judicial relief, including injunctive relief
for the violation of the article.
8.7
Agreement, Terms and Renegotiations
The parties acknowledge the during the negotiations which resulted in the Agreement, each had the
unlimited right and opportunity to make demands and proposals with respect to any subject or matter
not removed by law from the area of collective bargaining, and that the understanding and the
agreements arrived at by the parties after the exercise of that right an opportunity are set forth in this
agreement. Therefore, CUHW and the CWA, for the life of this Agreement, each voluntarily and
unqualifiedly waves the right, and each agrees that the other shall not be obligated to bargain
collectively with respect to any subject or matter referred to, or covered in this Agreement, or with
respect to any subject or matter not specifically referred to or covered in this Agreement, even though
such subject or matter may not have been within the knowledge or contemplation of either or both of
the parties at the time they negotiated or signed this Agreement.
This Agreement shall continue in full force and effect for three (3) years from January 4, 2012 through
January 3, 2015. If either party to this agreement wishes to negotiate a successor agreement, that party
will serve a request for negotiations on the other party not more than sixty (60) calendar days, nor less
than (30) calendar days prior to the above mentioned expiration date.
8.8
Signatures
In Witness Whereof, the parties hereto have caused their duly authorized representative(s) to execute
this Agreement on
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APPENDIX A
Wage Scale, Auto and Special Travel Allowances
Staff
Position
Effective
Date
Rate
Effective
Date
2012
Rate
Effective
Date
2013
Rate
2014
Pauline McKenzie
Auto Allowance:
$1,100/Mo.
Effective 1/12
Coordinator I
3/12
9/12
$45,000
$47,500
3/13
9/13
$50,000
$52,500
3/14
9/14
$55,000
$57,500
Nick Jiles
Auto Allowance:
$900/Mo.
Coordinator I
3/12
9/12
$45,000
$47,500
3/13
9/13
$50,000
$52,500
3/14
9/14
$55,000
$57,500
Tristan Brown
Auto Allowance:
$700/Mo.
Coordinator II
3/12
9/12
$500 Bonus
$500 Bonus
3/13
9/13
$62,000
$500 Bonus
3/14
9/14
$500 Bonus
$62,500
Ja-Key Robinson
Auto Allowance:
$900/Mo.
Coordinator II
3/12
9/12
$500 Bonus
$500 Bonus
3/13
9/13
$62,000
$500 Bonus
3/14
9/14
$500 Bonus
$62,500
Golden Sizemore
Leased Vehicle
Organizer I
3/12
9/12
$40,000
$42,500
3/13
9/13
$45,000
$47,500
3/14
9/14
$50,000
$52,500
Linda Zavala
Auto Allowance:
$700/Mo.
Organizer II
(F/T)
3/12
9/12
$50,000
$52,500
3/13
9/13
$55,000
$57,500
3/14
9/14
$60,000
$62,500
Patricia Medina
Auto Allowance:
$900/Mo.
Special Travel:
$500/Mo.
Organizer II
(P/T)
3/12
9/12
$30,000
$250 Bonus
3/13
9/13
$31,250
$250 Bonus
3/14
9/14
$32,500
$250 Bonus
Robert Caldwell
Auto Allowance:
$900/Mo.
Special Travel:
$500/Mo.
Organizer II
(F/T)
3/12
9/12
$30,000
$250 Bonus
3/13
9/13
$31,250
$250 Bonus
3/14
9/14
$32,500
$250 Bonus
Jana Eckerd
Bookkeeper
3/12
9/12
$0
$36,000
3/13
9/13
$36,500
$37,500
3/14
9/14
$38,000
$39,000
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APPENDIX B
CWA – Member Communication
CUHW agrees to allow employees to utilize CUHW property such as cell phones, office phones,
laptops, and any other modes of communication owned by CUHW for the purpose of allowing
employees to communicate CWA about union related matters. The CWA shall act in good faith to not
bring a substantial cost in either time or materials to communicate CWA matters amongst the
employees.
APPENDIX C
Monitoring
CUHW may utilize monitoring and surveillance as it deems appropriate and necessary.
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APPENDIX D
PAYROLL DEDUCTION OF DUES AUTHORIZATION
The undersigned hereby authorizes the California United Homecare Workers to deduct from my
wages an amount equal to the regular monthly dues as certified to the Employer by the SecretaryTreasurer of the Communications Workers of America or his/her duly authorized agent. Such deductions
may be made twice monthly to coincide with normal payroll practices of the Employer. This authorization
may be revoked by me at any time by written request to the Employer, or by written request by the
Secretary-Treasurer of the Union to the Employer’s appropriate representative.
Please Print Last_______________________
First _____________________ Initial _______
___________________________________________
Signature of Employee
SS# ____________________________
Resident Address ______________________________________________________________
City ___________________________________________________ Zip __________________
Home Phone# __________________________ Work Phone# ___________________________
Cell Phone# ______________________ E-Mail ______________________________________
Date Received by Employer ______________________ Effective Date ____________________
Employer: Please provide a copy of this form to the CWA Secretary-Treasurer upon recording.
Date Received by the CWA Secretary-Treasurer _____________________________________
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