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Business Unit: NSI - System & Application Integration Location Code: RO Address: Str. Timis, nr. 1, Sc. C, ap 4, Timisoara, Timis Home work area phone number (List any alternative contact numbers) +40-742941517 E Mail Address: sergiu.nicoara@alcatel-lucent.com
Employee Requirements 1) Detail the benefits of a teleworking arrangement for the employee, their work and the company. The benefits for the employee: transport savings, a better working schedule, more confortable, relaxed and quiet environment. The benefits for the company: savings in terms of electrical power, paper, parking tickets, quieter environment for the employees working in the office (being fewer people present) The benefits for the work: more efficency resulting from a better level of concentration.
2) A schedule (either weekly or monthly) indicating how the employee proposes to arrange their work around their home and office time. This schedule should be specific indicating actual days in and out of the office. The weekly schedule can mention maximum 2 days working from home, not Monday or Friday. Mon Tue Wed Thur Fri working at the Alcatel-Lucent Romania Office working at the Alcatel-Lucent Romania Office working at the Alcatel-Lucent Romania Office working from home (8.00 to 17.00 or 9.00 to 18.00 including 1 hour lunch break) working at the Alcatel-Lucent Romania Office
Example: 8.00 to 17.00 or 9.00 to 18.00 including 1 hour lunch break. Mon working at the Alcatel-Lucent Romania Office Tue working at the Alcatel-Lucent Romania Office Wed working from home Thur working from home Fri working at the Alcatel-Lucent Romania Office
4) Please identify the business expenses to be reimbursed by Alcatel-Lucent. 10 Euros/ month the internet subscription fee
5) Has Part B EH&S Home Office Setup and Assessment Checklist been completed indicating a positive result? YES NO 6) Has Part C IS Home Office Setup and Assessment Checklist been completed indicating a positive result? YES NO 7) Has Part D Assets List been completed indicating the equipment owned and registered by Alcatel-Lucent and the Teleworker? YES NO Terms and Conditions of Agreement This agreement pertains to the practice of working at home in a designated work area for a set period of time. All other terms and conditions of employment remain unchanged. This agreement is to be read in conjunction with the Teleworking Policy, and all areas of employee responsibility must be met otherwise this agreement is null and void. Alcatel-Lucent Romania retains the right to terminate the Teleworking Agreement at any time with one weeks notice. Employees wanting to terminate a teleworking agreement must give 10 days notice of intent to their immediate supervisor. The teleworking agreement is to be reviwed regulary, all 3 months at the most. Dates agreed to assess the Teleworking arrangement In One month ___________________________________ In Two months __________________________________ In Three months ________________X________________
Date:_______ __________________
Supervisor Requirements I have read the above proposal and am satisfied that ________Sergiu Nicoara__________ has met all the requirements necessary to undertake a teleworking arrangement. In addition I believe the arrangement would be beneficial to the individual and to the company. I have reviewed/inspected the designated work area and am satisfied that the area is a safe work environment and that the necessary security procedures are in place. I have read the Teleworking Policy and the Teleworking Agreement and have satisfied all my requirements. Name: Ovidiu Dobrean Title: Software Integration Team Leader Location: Timisoara Date:______________________
Signature:_________________________ Date:____________________________
Employees Home Address: _ Str. Timis, nr. 1, Sc. C, ap 4, Timisoara, Timis __________________________ Home Phone ____N/A_________________________________ Mobile Phone: _+40-742941517_______
Please attach photo of home office set-up and environment to last page. Working From Home Requirements If you have marked No to any requirement please refer to Alcatel Ergonomic Guidelines for adjusting your workstation and fix the problem. OFFICE REQUIREMENTS Office Space 1. Office to be situated away from the activities or other household members? 2. Is the workspace large enough to carry out work duties? 3. Is the workspace clean and well maintained? 4. Is there adequate storage for folders and work related resources? 5. Does the layout of the work site allow for easy access to furniture and computer workstation? 6. Is there enough lighting? 7. Is the electronic equipment ventilated? (Is there provided sufficient air space around electronic components?). 8. Is the area clear of trip and slip hazards? Is there a one meter square clearance at the entrance and the exit to the home office and building? 9. Are electrical /cable connections in good order and repair? 10. Are there sufficient power points? Desk Organisation 11. Desk organised to prevent undue twisting of the neck or trunk? 12. Frequently used items within easy reach (including the mouse) to avoid stretching? 13. Is there a copy holder or an area between the keyboard and monitor to place hard copy reference material? (NB// only when entering data into PC from hard copy). Monitor 14. When sitting tall and looking at your monitor, is your head in a straight and balanced position (your chin is not tucked down, or raised up)? If you wear multifocal glasses, is your monitor low enough so your head is straight and balanced when reading the screen? 15. Screen at a comfortable reading distance? (Normally positioned at arms length distance). SC Alcatel-Lucent Romania SRL Gh. Lazar, 9, 300881 Timisoara, Romania
YES YES YES YES YES YES YES YES YES YES YES YES YES
NO NO NO NO NO NO NO NO NO NO NO NO NO
YES
NO
YES
NO
NO NO NO NO NO NO NO
Instructions to Managers. If No marked for any section supervisors and employees will discuss remedial action if necessary. (If remedial actions are necessary, the Action Plan will be filled out). All actions to be addressed within one month of initial assessment otherwise the agreement for working from a home office will be revoked. Review recommended to occur at least once a year. ACTIONS TO BE TAKEN By When By Whom
Employees Signature_______________________
Managers Signature_____________________
NO NO NO NO NO NO NO NO
9. Identify the equipment to be used. Desktop Computer Printer Monitor 15" ____pppoe_______ ____50Mbps_________ ________________ ____________RDS______________ Fix line: Provider________________________Subscription type________ 17" Laptop Computer Description 21" __________________________________
Specific headphones
Costs supported by the company: Fix line telephony services fee paid at cost, capped at 10 EUR/month/employee reimbursed via XMS Toll free availability 0800895095 for services provided by Romtelecom 0741800501 for services provided by Orange Call international via 0256 250333 audio conf Employees Signature: ___________________________ Assessment Date: Managers Signature_____________________
August 2011