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01 KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) <br /> SECTION 1: EMPLOYEE DATA <br /> LAST NAME FIRST NAME EMPLOYEE# EFFECTIVE DATE <br /> Kauzlarich Tim K1164 07//2019 <br /> SECTION 2: TYPE OF ACTION <br /> EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION <br /> ❑FULL-TIME(1) []NEW HIRE ❑DISCHARGE(D) ❑PERFORMANCE(P) <br /> ❑PART-TIME(2) ❑RE-HIRE ❑RESIGNATION(Q) ❑ATTENDANCE(A) <br /> ❑LIMITED PART-TIME(3) ❑MERIT/STEP ❑RETIRED(R) ❑CONDUCT(C) <br /> ❑TEMPORARY(4) ❑POSITION CHANGE(Describe Below) ❑LAID OFF(L) ❑OTHER EMPLOYMENT(E) <br /> ❑CASUAL(5) ❑BUDGET CHANGE(Describe Below) ❑FAIL PROBATION(P) ❑PERSONAL(L) <br /> ❑SEASONAL(6) ❑LEAVE(List Type Below) ❑OTHER(0) ❑OTHER(0) <br /> ❑PROJECT(7) ❑TERMINATION(Provide Separation Info) <br /> ❑WORK-STUDY(8) ❑✓ OTHER(Describe Below) ❑Eligible For Rehire ❑Ineligible For Rehire <br /> ❑VOLUNTEER(9) Provide Details of Separation Below <br /> COMMENTS: Out-of-Class pay for Engineering Services Manager:task-Bridge Inspections. <br /> a monthly stipend equal to 5%of the starting salary[$5,934]of the vacant position [ESM],or$297.00.From July 2019-Dec <br /> 2019. <br /> SECTION 3: POSITION DATA <br /> Enterexisting data from CAMAS Wage Data Report Enter new data <br /> JOB TITLE TRAFFIC FOREMAN <br /> OCCUPATION CODE/PAY GRADE 4404 /404 / <br /> UNION CODE 40 <br /> STEP/POSITION 1 <br /> FLSA STATUS IE Non-Exempt ❑Exempt ❑Not Covered Q Non-Exempt ❑Exempt ❑Not Covered <br /> DRS STATUS ❑Ineligible 0 PERS ❑LEOFF ❑PSERS❑Other ❑Ineligible Q PERS ❑LEOFF ❑PSERS❑Other <br /> HIRE DATE 3/2/1998 <br /> ADJ HIRE DATE 3/2/1998 <br /> POSITION DATE 1/1/2017 <br /> LAST RAISE DATE 1/1/2019 <br /> BASE WAGE $30.78 $0.00 <br /> LONGEVITY $0.00 $ <br /> FTE Il l00% ❑80% ❑75% ❑60% ❑50% ❑p 100% [:180% ❑75% [:160% ❑50% <br /> FTE WAGE $30.78 $ <br /> PAYMENT METHOD E]HOURLY ❑MONTHLY Q HOURLY ❑MONTHLY <br /> DEPARTMENT PUBLIC WORKS <br /> BUDGET NUMBER A.000 RA3376 %: 100.00 A. %: <br /> B. %: B. %: <br /> WORKWEEK Il Standard ❑ALT/1"Friday off: ❑207(k) 0 Standard ❑ALT/1"Friday off: ❑207(k) <br /> COUNTY VEHICLE(For Commuting) ❑Required ❑Optional(taxable) Q N/A ❑ Required ❑Optional(taxable) ❑N/A <br /> To continue any allowance,stipend,or other,it must be listed in both columns for audit purposes or the amount will default to"0". <br /> ALLOWANCE(Detail in Comments Section) $0.00 $0,00 <br /> STIPEND(Detail in Comments Section) $0.00 $0,00 <br /> OTHER(Detail in Comments Section) $0.00 $297,00 <br /> SECTION 4: SIGNATURES(MUST BE SIGNED4N BLUE INK <br /> O ENT D/ LE DATE_ BUDGET/PAYROLL <br /> 4UAR' U DATE COMMISSI DATE <br /> DATE COMMISSION R. A E <br /> RETURN FORM TO HUMAN RESOURCES FdA D! R! UTlON <br /> Updated: 04/10/17 FOR HR USE: ❑NT Updated ❑ To Payroll—date: ❑ Scan to Dept. <br /> Prepared by:Liz Remeto on 7/10/2019 8:58:45 AM <br />