Remote Work Agreement

Employee Name: Employee ID#:

Employer/Ministry:

applicable to the arrangement for Employee to perform work for and/or on behalf of Employer at

a Remote Work Site. In addition to this Agreement, Employee agrees to adhere to Employer’s

Remote Work Policy, Trinity Health HR Operating Policy No. 460, as well as all other applicable

Employer policies and procedures. Capitalized terms used but not defined in this Agreement shall

have the meaning stated in Employer’s Remote Work Policy.

This Agreement is being completed for one of the following arrangements (select one):

□ Intermittent Remote Work: Working remotely less than 50% of normal work schedule,

whether regularly scheduled (e.g., once per week) or occasionally, as needed.

1. I understand that this Agreement may be modified, terminated, or revoked by the Employer

at any time, with or without reason. I understand that if this Agreement is terminated,

Employer will give me notice. I further agree to execute a revised Agreement upon

Employer’s request.

2. This Agreement is not a contract of employment and does not change my “at-will”

employment status. Either Employer or I may terminate my employment at any time, for

any reason, with or without cause, subject to the terms of any applicable collective

bargaining agreement. This Agreement shall automatically terminate if Employer’s

management notifies me that I must return to my assigned on-site work location, if

I understand that all equipment, documents, records, and materials (including files,

manuals, forms, etc.) provided by or on behalf of Employer or developed by me during the

course of my employment with Employer (collectively, the “Employer Equipment and

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Information”) shall remain the property of Employer. I further understand that only I am

authorized to use the Employer Equipment and Information, and that the Employer

Equipment and Information must be used for Employer business purposes only and I accept

responsibility for maintaining the security and confidentially of the Employer Equipment

and Information that are at the Remote Work Site. I agree to report instances of loss,

damage, or unauthorized access to or use of the Employer Equipment and Information to

my supervisor or manager at the earliest reasonable opportunity. Employer will provide

reasonable maintenance of the equipment that is Employer Equipment and Information. I

4. I understand and agree that my Remote Work Site will be my primary home address, as

identified in Workday (or Employer’s other HRIS system), which I have reviewed and

confirmed. I understand that I must notify my supervisor or manager if I intend to change

the Remote Work Site for more than two (2) consecutive weeks (e.g., due to a move or

extended stay away from the designated Remote Work Site). I further understand that my

Remote Work Site will be my principle work location for tax withholding purposes.

5. I understand that this Agreement does not change my normal work hours, which are

established with my manager or supervisor. I agree to remain accessible during my

• not work overtime without prior approval, in compliance with Employer’s policy

• take meal and/or rest breaks in compliance with applicable law and the Employer’s

6. I must obtain approval before taking paid time off or a leave of absence in accordance with

Employer’s regular policies and/or procedures.

7. I understand that my presence may be required at the discretion of Employer’s management

for meetings or for other purposes. I understand that I will be required to come to my on-

location and mileage. Travel to any other Employer or Trinity Health site required by

Employer’s management will be reimbursed subject to Trinity Health’s Travel and

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Business Expense Reimbursement Procedure, and/or any other Employer travel and

business expense reimbursement policy and/or procedure.

9. In the event business travel is required due to job related activities, Employer will

reimburse me for all reasonable and acceptable travel expenses consistent with Trinity

Health’s Travel and Business Expense Reimbursement Procedure, and/or any other

Employer travel and business expense reimbursement policy and/or procedure.

supervisor and my job performance will be regularly reviewed pursuant to Employer’s

policies and procedures. I understand that I may be given specific deliverables on a specific

timetable for when my work must be done when I work remotely. I acknowledge that

performance or productivity standards provided under any prior remote work agreement

remain in effect, unless otherwise agreed upon by my manger or supervisor. I understand

that if I fail to meet performance standards or deadlines, I may be subject to corrective

action, up to and including termination.

12. I understand that my salary and benefits remain the same while I am working remotely and

are subject to the terms and conditions of any applicable plans, programs, policies,

access to my Remote Work Site for purposes of maintenance of Employer-owned

equipment and/or retrieval of Employer-owned property, as necessary. I understand that

any cost associated with setting up and maintaining the Remote Work Site, including but

not limited to internet access, is my responsibility, unless Employer is otherwise required

to reimburse or offset such costs pursuant to state or local law.

14. Employer will not be responsible for operating costs, maintenance, or any other incidental

cost (e.g., utilities) whatsoever, associated with the Remote Work Site, unless otherwise

15. I acknowledge that I have received and signed a copy of Trinity Health’s Information

Services Procedure No. 1.1 – Acceptable Use. I understand and agree that I continue to be

subject to the Trinity Health Information Services Procedure No. 1.1 – Acceptable Use as

well as the Integrity and Compliance policies and procedures regarding proper handling of

Protected Health Information (PHI). I further acknowledge and agree that I will securely

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destroy (i.e., shred) any confidential Trinity Health or Ministry documents at the Remote

Work Site once they are no longer in use.

16. I agree to abide by any rules promulgated by Employer concerning the use of Employer

systems, data and computer equipment (including protecting against computer “viruses”)

and I understand that these rules may be changed at any time. I agree to follow any

Employer procedures for network access set forth in the Information Services Procedure

No. 1.1 – Acceptable Use and to take all necessary steps to protect the integrity of Employer

17. Employer will not be liable for damages to my property that may result from my Remote

Work. Employer will not be liable for any injuries that occur at the Remote Work Site

when I am acting outside the course and scope of my job duties. I agree to report any work-

related injuries to Employer at the earliest reasonable opportunity. I understand that any

injury occurring outside the Remote Work Site or while performing functions unrelated to

my employment shall not be considered work-related. I understand that I remain liable for

injuries or damage to the person or property of third parties and/or members of my family

on the premises of the Remote Work Site, and agree to indemnify and hold Employer

other agreed-upon location, at times identified by Employer.

19. This Agreement is the only Remote Work Agreement between me and Employer, it

supersedes and replaces any prior Remote Work or Telecommuting Agreement between

me and Employer, and it can only be amended or modified by Employer.