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PPMR 12-01 Section 1 General Provisions revison and additions Number: 12-01 Subject: Section 1 General p �1 Provisions Village of North Palm Beach Date: December 5, 2012 Revised: Section 1, Dated November 6, 2008 POLICY AND PROCEDURES MANUAL REVISION This revision re-numbers the paragraphs and adds the Village Higher Educational Assistance Program 1.0 GENERAL PROVISIONS 1.01 Purpose: To establish consistent and equitable policies concerning Village employment and to establish workable guidelines for the implementation of these policies. 1.02 Scope: These regulations pertain to all personnel whose name appears on the Village payroll or receive compensation from the Village of North Palm Beach, except elected officials, members of commissions and committees appointed by the Village Council, consultants or others providing services under contract to the Village and temporary employees hired to meet the immediate requirements of an emergency condition which threatens life or property. Volunteer personnel, by definition, are also excluded from these regulations. Employees subject to collective bargaining agreements as negotiated in accordance with Florida Statutes shall be exempt from provisions of these regulations which are inconsistent with such agreements. 1.03 Amendment of Regulations: Amendment of subject Rules and Regulations may from time to time be proposed and approved by the Village Manager. 1.1 Harassment- Discrimination: A. Definitions: 1. Adverse Impact: Employment process that does not necessarily intend to exclude people of a particular race, national origin, gender, or religion, but its practices has the effect of doing so. 2. Discrimination: Fundamentally defined as different or disparate treatment and neutral conduct that has an adverse impact on groups protected by law. 3. Disparate Treatment: Intentional discrimination in which employment decisions are determined based on an individual's race, gender, religion, color, national origin, or disability. B. Non-discrimination/Equal Employment Opportunity: The village's policy is to provide equal employment opportunity without regard to race, color, creed, gender, sexual preference, national origin, ancestry, age, religion, disability, or as otherwise required by law. The village's policy of equal employment opportunity covers, but is not limited to matters of recruitment, selection, assignment, compensation, training, promotion, transfer, discipline, and termination. C. Americans With Disabilities: The Village prohibits discrimination against people with disabilities in regard to any employment practices, terms, conditions, and privileges of employment. 1. Purpose: The purpose of this policy is to conform to the Americans with Disabilities Act (ADA) as legislated by the U. S. Congress under Public Law 101-336 and codified as 42 U.S.C. 12101-12213. As such, the Village in the adoption of this policy assures that its applicant process, employment practices, policies and procedures do not discriminate against individuals with disabilities. 2. Application: A qualified individual with a disability means an individual with a disability who: a. Satisfies the requisite skill, experience, education and other job related requirements of the position such individual holds or desires; and, b. With or without reasonable accommodation can perform the essential functions of the position. 3. ADA Coordinator: The designated coordinator for all ADA issues for the Village of North Palm Beach is the Village Manager or his designee. 4. Policy: It is the policy of the Village of North Palm Beach to abide by all provisions of the Americans with Disabilities Act. The Village will not discriminate against any individual who demonstrates the qualifications necessary to perform the duties of a particular position in the organization. No medical or physical disabilities will be considered as a factor in satisfactorily performing a job/task except for those which are critical to the performance of such task. A reasonable accommodation will be sought for otherwise qualified persons with permanent, substantially limiting physical or mental disabilities as required by the Americans With Disability Act (ADA). Reasonable accommodations will be accomplished as follows: a. A reasonable accommodation may consist of modifications or adjustment to the work environment, in the manner or circumstances in which the job customarily is performed or provide alternative lateral employment for which the individual is qualified. b. A reasonable accommodation will seek to assist a qualified employee in the performance of essential job functions of the job the employee currently holds. c. Employees requiring an employment accommodation must contact the Human Resources Director or Director for receipt of an application. d. Employees seeking an accommodation under the provisions of the Americans With Disability Act must be disabled as defined by the statute. Employees must certify that their physical and/or mental conditions substantially limit a major life activity. e. Eligible employees are those that satisfy the requisite skill, experience, education, and other job-related requirements of the position held and who with or without reasonable accommodation can perform the essential function of the position. f. The Human Resources Director will determine and advise employees if they are eligible under the provisions of the Americans With Disabilities Act and if reasonable accommodations can be made. g. Prevention of Discrimination: Anyone who, in good faith, was discriminated against as described in this policy or who, in good faith, has observed such discrimination should promptly report such conduct in accordance with the provisions set forth in this policy. 5. ADA Grievance Procedure: a. Purpose: This grievance procedure is specifically applicable for Americans with Disabilities Act (ADA) complaints. All other grievances will be processed under the Village's Grievance Procedure in Section 14 of the Personnel Rules and Regulations. 6. Steps—Grievance Procedure: STEP 1: An aggrieved employee will submit all complaints regarding access or alleged discrimination in writing to his/her respective department director for resolution. A record of the complaint and action taken will be maintained. A decision by the department director will be rendered within fifteen (15)working days. STEP 2: If the complaint cannot be resolved to the satisfaction of the complainant by the department director, it will be forwarded to the Village Manager within three (3) working days following resolution in Step 1. The Village Manager will have ten (10) working days to respond to the complaint. If the complaint cannot be resolved to the satisfaction of the complainant by the Village Manager, it will be forwarded to an ADA Compliance Committee composed of a representative appointed by the Village Manager, a representative appointed by the complainant and a third representative appointed, by mutual agreement by the two representatives appointed by the Village Manager and the complainant. STEP 3: The committee will establish ground rules and procedures for hearing complaints, requests or suggestions from the complainant regarding access to and participation in public facilities, services, activities and functions in the community. The committee is directed to hear such complaints in public, following due public notice. The committee will meet and issue a written decision within thirty (30) days of the public notice. The public notice will be posted within five (5) working days following the establishment of the committee. All proceedings of the committee will be recorded and records of the committee will be subject to the Florida Public Records Law. STEP 4: If the complaint cannot be resolved to the complainant's satisfaction by the committee, the complaint will be heard by the Village Council. An open, public meeting of the Council will precede any action taken by the Council A determination must be made within thirty (30) days of the matter being referred to the Village Council The decision of the Village Council will be final. 7. Records: A record of action taken on each request or complaint must be maintained as part of the public records at each level of the grievance process. 8. Other Remedies: The individual's right to prompt and equitable resolution of the complaint must not be impaired by his/her pursuit of other remedies such as filing of a complaint with the U.S. Department of Justice or any other appropriate Federal agency. Furthermore, the filing of a lawsuit in State or Federal District Court can occur at any time. The use of this grievance procedure is not a pre-requisite to the pursuit of other remedies. D. Harassment in any form will not be permitted in the workplace. Harassment is described as engaging in a course or pattern of unwanted verbal, nonverbal, or physical conduct directed at a particular person or group, serving no legitimate purpose and includes, but is not limited to words, gestures, touches, innuendos, epithets, propositions, threats, or other actions which annoy, alarm, frighten, abuse, or insult another person in any manner. E. Any person harassed by an employee or non-employee in the work environment should promptly take the following steps: 1. The person should promptly and politely inform the offending party to immediately cease and desist from the objectionable activity. Failure to make such a request will not excuse the offending party for any unauthorized actions. Written notification to the offending party of the demand to cease is suggested, with a copy sent to the complaining employee's supervisor including all relevant details of the complaint. The supervisor will make periodic inquiries to ensure offending actions have ceased. 2. If some adverse consequence might result from a direct confrontation, the complaining employee's supervisor should be immediately consulted. 3. If the offending party is the employee's supervisor, the complaining employee will have the option to: a. Notify the next level of the employee's supervisory chain. b. Contact a supervisor of the same gender c. Contact the Human Resources Director F. Nothing in this section is intended to prevent any aggrieved employee from pursuing any complaint through another appropriate investigative authority or agency. G. Supervisory and management employees will continually work to discover and eliminate unreported instances of harassment. They will strive to create a non-hostile work environment for all employees. H. Nothing in this section will be construed to restrict supervisors from their appropriate administration of supervisory duties such as dissemination of counseling, discipline, and duty assignments. I. Complaints of harassment will be fully investigated. J. Nondiscrimination/Anti-Harassment/Equal Employment Opportunity: 1. The Village provides reasonable accommodations to otherwise qualified persons with disabilities as required by the Americans With Disabilities Act. 2. The Village does not tolerate harassment in the workplace in any form, including sexual harassment. Any employee found to have engaged in harassment will be subject to prompt disciplinary action, including termination. 3. All management and supervisory staff are strictly accountable for maintaining a suitable work environment in accordance with this policy and applicable law. Such accountability includes communicating this policy to all their employees. 4. All management and supervisory staff are expected and held accountable to take affirmative measures to prevent, recognize, and correct any instances of discrimination or harassment. 5. Management and supervisory staff will be subject to disciplinary action including termination, for participating in or failing to correct instances of discrimination or harassment. 6. Prevention of Discrimination: Anyone who, in good faith, has been discriminated against as described in this policy or who, in good faith has observed such discrimination should promptly report such conduct in accordance with the provisions set forth in this policy. 7. Prevention of Harassment: The Village intends to maintain a work environment free of sexual harassment or harassment of any kind, including harassment on the basis of race, religion, color, creed, gender, sexual preference, national origin, ancestry, age, disability, or any other basis. Accordingly, the Director has established procedures for the prompt investigation and resolution of reports of harassment. K. Sexual Harassment: 1. Sexual harassment consists of unwanted sexual pressure, sexual attention or advances, or conduct initiated by any employee, contractor, or agent of the Village toward any other in the form of verbal abuse or invitation, unwarranted sounds, gestures or innuendos, suggestive correspondence, posters, calendars, photographs or remarks, or any form of unwelcome physical contact or suggestion. 2. It is unlawful and expressly against Village policy for any employee, male or female, to sexually harass another by: a. Making submission to or rejection of unwelcome sexual advances or requests for sexual favors or engaging in other verbal or physical conduct of a sexual nature, a condition of any employee's continued employment, position, promotion or compensation. b. Making submission to or rejection of such conduct as described in Section J1 the basis for determining employment, position, promotion, or compensation. c. Making submission to or rejection of such conduct as described in Section J1 the basis for any employment decision affecting the employee. d. Creating an intimidating, hostile, or offensive working environment by such conduct as innuendos and/or suggestive remarks, or physical contact, which an employee finds offensive. L. Discipline for Discrimination and Harassment: Any employee who has discriminated against or harassed another employee will be subject to disciplinary action including termination. M. Duty to Report Harassment/Discrimination: 1. Any harassment or discrimination directed toward another person must be immediately reported to the appropriate person. 2. All reports of harassment or discrimination will be thoroughly investigated and held in confidence to the maximum extent practical while conducting a thorough investigation and in accordance with applicable law. 3. Employees will not suffer retaliation for a good faith report of harassment or discrimination. 4. Nothing in this policy is intended to limit, discourage, or restrict any other remedies or avenues of redress an employee may have under applicable law. N. Complaint Filing Process: 1. Any employee who in good faith, was subjected to discrimination or harassment by a supervisor, subordinate, peer, service contractor, or the public or, in good faith, has observed or has knowledge of discrimination or harassment against another person, must promptly report the incident to the appropriate village supervisor or Human Resources Director or directly to the Village Manager. 2. Reports of discrimination or harassment will be kept confidential to the maximum extent practicable. An employee's failure to report actual incidents of harassment or discrimination may result in disciplinary action in accordance with policy and procedures. O. Report Processing and Investigations: 1. The Human Resources Director will perform the initial processing of all complaints of discrimination or harassment submitted pursuant to this policy. 2. Reports of discrimination or harassment filed with village supervisors will be forwarded immediately or as expeditiously as reasonably possible to Human Resources Director for initial processing. The Village attorney will also immediately receive a copy of any report of discrimination and/or harassment as described in this policy. 3. The Village will pursue an informal resolution of potential issues reported under this policy when the Human Resources Director believes such methods are reasonably likely to yield an appropriate result in accordance with this policy and applicable law. Notwithstanding the above, when the reporting party raises issues of harassment, certain immediate preventative measures generally are appropriate. For example, a person making a good faith report of harassment may elect an immediate, temporary transfer to a position within the Village at the same pay and benefits, to preclude further contact with the alleged offender. 4. Upon receipt of a report of discrimination or harassment, the Human Resources Director or designee will review the allegations of the report and when practicable, conduct a preliminary, informal interview with the reporting party within two business days. 5. If the report involves allegations of harassment, the Human Resources Director or designee will immediately or as soon thereafter as reasonably possible, meet with the Manager or designee to determine the appropriate measures to protect the rights of all parties involved. 6. If the Human Resources Director cannot resolve the matter of a report of discrimination or harassment informally, the Human Resources Director will forward the report to Village Manager or designee for a formal investigation. The Human Resources Director will upon request, continue to provide technical assistance during the formal investigatory process. P. Right to File Charges With State and Federal Agencies: 1. Employees who feel they were discriminated against or harassed have the legal right to file charges with federal, state, and/or local agencies such as the Palm Beach County Human Rights Division. 2. Proceeding under this policy does not preclude filing a charge of discrimination or harassment with an outside agency. Specific time limitations apply to charges filed with outside agencies and proceeding under this internal policy does not stay these limitations, which generally start running from the date of the alleged unlawful act. Q. Human Resources will give to each new employee during new employee orientation a copy of this Harassment policy and approved Certification memo for completion. The Certification memo will be distributed as follows: 1. Original —Village Personnel file 2. Copy —employee 1.2 Higher Educational Assistance Program: The Village of North Palm Beach encourages employees to voluntarily pursue training programs, undergraduate and graduate degrees or professional certifications that will improve and enhance their skills, performance, and ability to assume additional responsibilities at the Village. Accordingly, subject to budgetary restraints, the Village will provide educational assistance to eligible employees who are seeking a qualifying undergraduate or graduate degree or professional certification, or who are obtaining job-related training. Assistances and other payments made by the Village to an eligible employee under this policy are subject to the current federal taxation requirements. A. Employee Eligibility: 1. To be eligible, employees must be employed by the Village on a full-time basis for at least one year (12 months) of continuous service in an active status (not on a leave of absence) and must be in good standing at the time of application for assistance and on the date of the assistance payment by the Village. 2. For purposes of this policy, the Village defines "good standing" as an employee who has not received any formal corrective action, discipline, performance improvement plan or an unsatisfactory performance evaluation within the last 6 months. 3. Employees must also be currently employed at the time that payment is made. All said employees are eligible unless superseded by a current Collective Bargaining Agreement. B. Undergraduate and Graduate Programs: 1. Course Eligibility: Undergraduate and graduate courses must be taken as part of a degree program approved in advance by the Department Director, Human Resources Director, and the Village Manager, and must provide an eligible employee with skills, knowledge or competencies applicable to the employee's current position or another position at the Village. The courses must be provided by an accredited university or college that meets the acceptable levels of quality set by an accrediting agency that is recognized by the U.S. Secretary of Education, as published in the Federal Register. 2. Grade Requirements: An employee must maintain a "C" average or above to maintain eligibility in the Village's program after completion of the first semester of classes. 3. Tuition Assistance Provisions: An employee is eligible to receive assistance for two (2) classes per semester for a maximum of five (5) classes per fiscal year. The amount of assistance approved by the Village will be based on the employee's grade in each course, as provided in this policy. Books, and required laboratory fees are eligible for assistance, but shall be limited to $250 per fiscal year. All other expenses, including but not limited to, those for parking, supplies or non-laboratory fees, are the employee's responsibility and are not eligible for assistance from the Village. 4. Assistance Amount: The assistance amount will be limited to actual tuition, or the per credit rate of the established Florida resident credit hour rate for undergraduate or graduate courses charged in the State of Florida university system at the time of the employee's course enrollment, whichever is lower, regardless of the employee's election to attend a private educational institution. Upon the employee's completion of an approved course, the assistance schedule will be based on grades received by the employee as follows: 100% assistance for a grade of "A", or "Pass" (for Pass/Fail course only); 100% assistance for a grade of "B" and 75% assistance for a grade of "C". The Village will not provide any amount of tuition assistance if the employee earns a grade of"D" or "F" or receives a "Fail" or "Incomplete" mark. 5. Courses must be scheduled outside of the employee's regular work hours and all homework or related coursework must be done outside of working hours. Employees are prohibited from using Village equipment or resources to engage in homework or other related coursework. NOTE: The Village may reduce the percentage of assistance if the combined total of the employee's financial assistance and the Village's assistance to the employee exceeds 100% of the tuition, book costs and laboratory fees for the course term. C. Certification or Training Programs: 1. Program Eligibility: An eligible employee may obtain assistance for a certification program or courses in a professional discipline applicable to the employee's current position or another position at the Village and for job-related training courses or programs (collectively referred to as "certification or training programs"). The certification or training programs must be provided by an accredited university or college that meets the acceptable levels of quality set by an accrediting agency that is recognized by the U.S. Secretary of Education, as published in the Federal Register, professional association, professional training provider, or other similar institution. The employee's participation in any certification or training program must be approved in advance by the Department Director, Human Resources Director, and the Village Manager. This policy only applies to certification or training programs that cost $1,200.00 or more, inclusive of registration and attendance fees and related expenses, such as travel, lodging and food. 2. Tuition Assistance Provisions: An employee is eligible to receive assistance for up to two (2) certification or training programs per semester. If the certification or training program consists of courses or sessions that occur over a period of time, similar to the semester-based system for undergraduate or graduate degree programs, the Village will follow the "Tuition Assistance Provisions" contained in the Undergraduate and Graduate Programs section of this policy. 3. Assistance Amount: The assistance amount will be determined by the Village at the time of approval on an individual employee basis, in consideration of the nature of the certification or training program, the employee's position, the Village's operational needs, and the tuition, attendance or registration costs and the related expenses, such as travel, lodging and food. a. Any amount paid by the Village in connection with a Village approved training program shall not exceed the reimbursable travel expenses authorized under Section 112.061, Florida Statutes. b. The Village will provide assistance to an eligible employee who successfully completes the approved certification or training course or program, up to a maximum of $5,250.00 per fiscal year based on the date of the check to the employee. The Village will not provide any assistance to an employee who does not successfully complete the certification or training course or program. D. Approval Procedure: 1. Eligible employees must receive prior approval from the Village Manager in writing to participate in the Village's educational assistance program. 2. To obtain approval, an eligible employee must submit a completed Education Assistance Program Participation form to his or her Department Head with the following documents attached: the course or program description; an agenda or schedule (with dates and times); and for training or certification programs only, the program cost and a list of the categories and costs of any related expenses. 3. The Department Head and the Human Resources Director will review the employee's form and supporting documentation to determine if the employee meets the criteria for participation in the Village's Educational Assistance Program. If the employee is eligible to participate in the program, the Village Manager will evaluate and either grant or deny the employee's request. Notice of the Village Manager's decision shall be provided to the employee in writing. E. Program Terms: 1. The assistance amounts provided to eligible employees by the Village are considered a loan for educational expenses. Accordingly, if the employee is approved to participate in the Village's educational assistance program, the employee is required to remain employed with the Village in a full-time capacity for a continuous 12 month period from the date of each assistance payment received by the employee or on the date that the Employee completes the undergraduate or graduate course or the certification or training program, whichever is later. 2. If the employee completes the 12 month period of employment, the Village will forgive the loan for that 12 month period. However, if the employee resigns or terminates employment at any time during the 12 month employment period (for any reason other than due to a reduction in force or due to circumstances beyond the employee's control, as determined by the Village Manager), the Village will forgive the loan on a pro rata basis. The prorated amount will be calculated as follows: the total assistance amount in the prior 12 month period divided by the number of months of the employment period completed by the employee. The balance of the loan not forgiven under this policy is due in full within seven (7) days of the employee's separation from employment. In appropriate circumstances, the Village and employee may agree to a monthly payment plan for repayment of the balance of the loan. 3. The Village also may retain and deduct the amount owed under this Policy (in whole or in part) from any monies due to the employee prior to or following his or her termination, subject to the applicable restrictions imposed by the Fair Labor Standards Act. The employee will submit a signed, notarized promissory note guaranteeing full repayment for all education expenses if the terms of this policy are not fulfilled on the side of the employee, which shall include an express lien on all wages or other payments due the employee in accordance with applicable laws. 4. An eligible employee who receives assistance to attend a basic recruit training program for law enforcement officers is required to comply with the employment and repayment terms provided in Florida Statutes section 943.16, which includes a two-year employment commitment from the employee to avoid the repayment provisions. NOTE: An employee who participates in the Village's educational assistance program is employed at will and the employee's employment may be terminated by the employee or the Village at any time, with or without cause or prior notice. This policy does not create a contractual relationship between the Village and any employee participating in the Village's educational assistance program, and does not create a guarantee of employment for a definite period of time or for any purpose. F. Payment and Assistance Procedures: 1. If approved to participate in the Village's educational assistance program, the employee shall submit proof of cost of his or her tuition, laboratory fees, registration and attendance costs, and related expenses. a. If the documents produced by the employee are satisfactory, the Department Head will complete a Personnel Action Form (PAF) indicating approval to proceed with assistance. b. The PAF form must be submitted to the Human Resources Director and then forwarded to the Village Manager for final approval. If approved, the PAF will be submitted to payroll for processing. c. The employee will then submit a signed, notarized promissory note to the Village guaranteeing full repayment for all education expenses if the terms of this policy are not fulfilled on the side of the employee. The signed promissory note must be received by the Village prior to any payment being made. 2. Within thirty (30) calendar days of successful completion of the approved course(s), program or training, the employee must provide to his or her Department Head copies of all receipts for all additional eligible costs and fees and one of the following: certified transcript for the course term for any undergraduate and graduate courses, copy of professional certification, or a certificate of completion for a training program. a. The employee shall also disclose and provide documents showing all financial assistance (including, but not limited to, scholarships, grants, stipends, waivers, discounts, fellowships, military and veterans' benefits) and other non- refundable financial assistance received by the employee used to pay tuition or other costs. b. The combined total of the employee's financial assistance and the Village's assistance to the employee shall not exceed 100% of the tuition and eligible costs and fees. The assistance amount may be reduced to satisfy this rule. G. Termination of Employment: If the employee resigns, submits a resignation, or is terminated by the Village for any reason other than due to a reduction in force or due to circumstances beyond the employee's control (as determined by the Village Manager), prior to receiving assistance for a completed course(s) or program, the Village (at t he Village Manager' s Discretion) may forgive the loan on a pro rata basis. If an employee is laid off from employment with the Village, the employee will be eligible for assistance of approved undergraduate or graduate courses in which the employee is enrolled at the time of layoff. Assistance will be determined in accordance with this policy. Approved e. Ed Green Village Manager PROMISSORY NOTE North Palm Beach, Florida Employee Name: Amount: $ Date: FOR VALUE RECEIVED, the undersigned (referred to as "Maker") promises to pay to the order of the Village of North Palm Beach, Florida (referred to as "Holder") the principal sum and 00/100 Dollars ($xxx.xx), together with interest thereon at a rate equal to zero percent (0%) per annum, with all outstanding principal and interest thereon due and payable in full in accordance with the terms of this Note on or before [INSERT DATE] (the "Maturity Date"). Principal and interest shall be payable in lawful money of the United States of America and in such place as Holder may designate in writing on the following dates and in the following Manner: Maker shall pay Holder the sum of and 00/100 Dollars ($XXX.XX) on [INSERT DATE], and continue to make monthly payments of and 00/100 Dollars ($xxx.xx) due on the first day of each successive month until the debt is paid in full. If any payment hereunder is not received at the following address: Village of North Palm Beach, 501 US Highway 1, North Palm Beach, FL 33408, within three (3) days after it is due, Makers shall pay to Holder a late charge equal to five percent (5%) of the late payment. If default be made in the payment of any sums or interest mentioned herein within five (5) days next after the same becomes due, or in the performance of any of the agreements contained herein, or in the said Agreement, then the entire outstanding principal sum and accrued interest shall at the option of the Holder hereof become at once due and collectible without notice, time being of the essence; and said principal sum and accrued interest shall both bear interest from such time until paid at the highest rate allowable under the laws of the State of Florida. Failure to exercise this option shall not constitute a waiver of the right to exercise the same in the event of any subsequent default. The Maker agrees to pay the Holder hereof reasonable attorneys' fees and costs incurred by counsel employed to collect this Note, whether or not suit be brought, and whether incurred in collection, trial, appeal, post judgment proceedings, bankruptcy proceedings or otherwise, and to indemnify and hold Holder harmless against liability for the payment of state documentary stamp taxes, intangible taxes or other taxes (including interest and penalties, if any, but not including the Holder's obligation to pay state or federal income taxes arising out of its receipt of income from this loan), which may be determined to be payable with respect to this transaction. The remedies of Holder as provided herein and in any other documents governing or securing the repayment hereof, shall be cumulative and concurrent, and may be pursued singly, successively or together, at the sole discretion of Holder, and may be exercised as often as occasion therefore shall arise. No act of omission or commission of Holder, including specifically any failure to exercise any right, remedy or recourse, shall be effective, unless set forth in a written document executed by Holder, and then only to the extent specifically recited therein. A waiver or release with reference to one event shall not be construed as continuing, as a bar to, or as a waiver or release of any subsequent right, remedy or recourse as to any subsequent event. The correct legal address of the Maker of this Note is , and is the address to be used for any legal notice. The Maker agrees to inform the Holder of any changes of this address in writing within ten (10) business days of such change. The Maker and endorser waives presentment, protest, notice of protest and notice of dishonor. This Note shall be construed and enforced in accordance with the laws of the State of Florida and shall be binding on the heirs, personal representatives, successors and assigns of the parties hereto. IN WITNESS WHEREOF, Maker, intending to be legally bound hereby, has duly executed this Note, under seal, as of the day and year first above written. EMPLOYEE SIGNATURE (MAKER) VILLAGE OF NORTH PALM BEACH t APPLICATION FOR EDUCATION ASSISTANCE Name (print): Telephone: Position: Department I request approval to enroll in course: *(Please attach course description) at(institution) beginning / / Ending / / Number of Credits @ amount per credit(s) Time of class(es) I am taking the course (check below): Toward a(n): ❑ Associate's ❑ Bachelor's ❑ Master's ❑ Doctorate in the following course of study (be specific): To enhance my skills for my present position. HR Use Only For career redirection or advancement. Amount Paid Y-T-D: Estimated Pending: Tuition for the Course $ Total Pending: Available: Enrollment Fees $ Estimated Amount Available if 100% Cost of Required Books $ Tuition Reimbursement Received for Pending:: 1. Is the course required to meet minimum educational requirements for your current job? ❑ Yes ❑ No 2. Does the course provide with the capability of qualifying for a new position at the Village? ❑ Yes ❑ No 3. If you answered yes to either#1 or#2, briefly provide an explanation as to how the course is either required to meet minimum educational requirements for your current job or provides you with the capacity to qualify for a new job. APPROVAL OF COURSEWORK Department Director Signature Date Director of Human Resources Signature Date Village Manager Signature Date By signing I agree to the following: I have read,understand, and agree to comply with the provisions of the Village's Education Assistance policy or similar provision in the applicable collective bargaining agreement. I will only receive reimbursement for approved coursework, not to exceed $5,250 in the calendar year the course(s) is/are taken. If I receive disciplinary action, am placed on a Performance Improvement Plan or receive a performance appraisal rating of"Needs Improvement" during the period that I am taking an approved class, I may be required to forfeit the tuition reimbursement for that course. I also understand that if I voluntarily or involuntarily separate from the employment of the Village for any reason other than reduction in force or due to circumstances beyond my control within twelve (12) months of satisfactory completion of the course work for which I have been reimbursed, the agreed amount of the cost of educational course will be considered only a loan. Accordingly, I will be required to reimburse the educational course expense in full prior to my last date of employment, or through such other collection means as the Village deems appropriate. As such, I hereby give the Village of North Palm Beach an express lien on all salaries, wages and other sums payable to me by Village for the purpose of securing the Village for the payment of any amount which may become due from me and have attached an executed promissory note for amounts due if the cost is to be considered only a loan. I further hereby authorize the Village to deduct said amount from any sums payable to me for salaries, wages, and expense reimbursement or otherwise. Moreover, I specifically authorize the Village to retain sums payable to me in the form of salaries,wages and other sums on or before issuance of my final paycheck. Proof of registration, receipts for tuition, enrollment fees and required books as well as the official school grade report and documentation of outside financial assistance will be required before reimbursement can be approved(please attach). Employee Signature Date HR Use Only Tuition: Enrollment: Books: Lab Fees: Total: APPROVAL FOR PAYMENT Course completed. Grade attained Education Reimbursement % Eligible for: $ ❑ Taxable ❑ Non-Taxable Director of Human Resources Signature Date Finance Director Date Village Manager Date