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HomeMy WebLinkAbout2017-02-13-minutes-hr-study-sessionCOMMISSIONERS' MINUTES KITTITAS COUNTY, WASHINGTON BOCC CONFERENCE ROOM SPECIAL MEETING HR STUDY SESSION MONDAY 11:00 AM February 13, 2017 Board members present: Obie O’Brien, Paul Jewell, Laura Osiadacz Others: Lisa Young, Clayton Myers, Greg Zempel 1) Call to order – 11:02 AM 2) Staffing Discussion and/or Requests  Sheriff’s Office – Undersheriff Myers was present to discuss two items: 1) Request wage survey adjustments – Undersheriff Myers requested the ability to make wage survey implementation adjustments that would be budget neutral; the Board discussed the potential f uture impact of the changes; Undersheriff Myers said all impacts were considered when they were contemplating the change; the Board approved. 2) Request to add a 5th Line Corporal – Undersheriff Myers requested the ability to add a 5th Line Corporal to their staff. The 2017 budget allowed them to hire an additional Line Deputy which they are in the process of doing. He discussed their need to have a supervisor over the MCU division. They would like to assign a current Corporal experienced in electronic forensics to oversee that division, and then initiate a promotional process through Civil Service to create a Corporal roster for the 5 th position. The vacancy created by the promotion would not be back-filled in 2017, and the need to fill would be reviewed as part of the 2018 budget process. Undersheriff Myers said the salary difference between a step five Deputy and a Corporal would be budget neutral for 2017 due to the delay in hiring for current vacancies and the delay in hiring the new Corporal. Chairman Jewell asked how the difference would be budget neutral in future years. After a lengthy discussion, Undersheriff Myers indicated that the funding they receive from other agencies to provide forensic analysis of electronics should offset the cost difference. In order to ensure the revenue vs. expense is accounted for as we approach the 2018 budget process, HR Director Young will create a calendar reminder and include Undersheriff Myers. The PAF of the newly promoted Corporal will reflect reliance upon revenue from technology agreements, as will the amended org chart. Commissioner O’Brien moved to approve the 5th Corporal position under the funding expectations discussed; Commissioner Osiadacz seconded. The COMMISSIONERS' MINUTES KITTITAS COUNTY, WASHINGTON BOCC CONFERENCE ROOM SPECIAL MEETING HR STUDY SESSION motion was approved 3:0.  Prosecutor’s Office – Tabled until next HR Study Session because the meeting ran longer than expected and the Prosecutor had another obligation.  Fire Marshal – Commissioner Osiadacz provided an update to the Board on her Fire Marshal research. She provided three scenarios for the Board to consider. Chairman Jewell asked her to obtain more detailed data on the first two options, including timelines, training requirements, and a cost-benefit analysis. He suggested that a meeting be set for the Board to meet with KFVR and another one to meet with CDS for further discussion. 3) HR Projects – Tabled for the next HR Study Session.  Wage Survey  Benefits Project  HIPAA Assessment  Leave Report 4) Request to Approve PAF’s (Personnel Action Forms) – Director Young presented PAF’s for Board signature; they were approved and signed as presented. 5) Safety and Security – Tabled for the next HR Study Session. 6) Other Business – Commissioner O’Brien asked the other Commissioners about a citizen request regarding the bowling alley. Chairman Jewell reported that the interested party was told to put together a proposal for the Board to consider. 7) Adjourn – 12:15 PM KITTITAS COUNTY COMMISSIONERS KITTITAS COUNTY, WASHINGTON Lisa Young Paul Jewell, Chairman KITTITAS COUNTY PERSONNEL ACTION FORM (PAFI Updated: 04/08/11 FOR HR USE: NT Update Eval Date EvalRating(IE—ID—S —AA—S) Initial SECTION 1: EMPLOYEE DATA LAST NAME Hodges FIRST NAME Karen EMPLOYEE # EFFECTIVE DATE H2715 01/01/2017 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ❑✓ FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE J'$TPP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ERMINATION (Provide Separation Info) ER (Describe Below) ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ RETIRED (R) ❑ CONDUCT (C) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ OTHER (0) ❑ OTHER (0) ❑ Eli ible For Rehire g' ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Increase per wage survey - payment effective 1/1/17; deferred until February payroll. SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE PLANNER III OCCUPATION CODE 2492 UNION CODE 40 PAY GRADE 292 STEP /POSITION 6 FLSA STATUS ❑' Non -Exempt ElExempt [:1p Not Covered ❑� Non -Exempt ❑ Exempt ❑Not Covered DRS STATUS ❑ Ineligible [j) PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible El PERS ❑ LEOFF [I PSERS ❑ Other HIRE DATE 7/11/2016 ADJ HIRE DATE 7/11/2016 POSITION DATE 7/11/2016 LAST RAISE DATE BASE WAGE $ 5,000.00 $5,�va.00 LONGEVITY $ 0.00 $ FTE EE l00% ❑ 8or ❑ 75% ❑ 60% ❑ 50% F!] 100% ❑ 80% [175% ❑ 60 ❑ 50% FTE WAGE $ 5,000.00 $ 5,500.00 PAYMENT METHOD ❑ HOURLY ❑� MONTHLY ❑ HOURLY ❑� MONTHLY DEPARTMENT PUBLIC WORKS BUDGET NUMBER A. 000 RA3376 %: 100.00 B. 000 RA3376 is 100.00 A. %: B. %: WORKWEEK 0 Standard ❑ ALT/1" Friday off: ❑ 207(k) [E Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $ 0.00 $ 0.00 STIPEND (Detail in Comments Section) $ 0.00 $ 0.00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES (MUST BE S] ED IN BLUE INK) AER,ARTMENTHEAD/TED OFFICI I. `► �vus4Lla DATE N b O 1 o ai 0.1`1 BUDGE /PAY Lk 7E A' , ori MA RE U £ DATE COMMIS$ 91. DA C R DA7T COMM11W.ER,% p E RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update Eval Date EvalRating(IE—ID—S —AA—S) Initial KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) LAST NAME Hodges SECTION 1: EMPLOYEE DATA FIRST NAME EMPLOYEE # Kelee H2567 SECTION 2: TYPE OF ACTION EFFECTIVE DATE 01/01/2017 EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ❑� FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT(7) [:1WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE F2SjMt51TTMTEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) TERMINATION (Provide Separation Info) THER (Describe Below) ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ RETIRED (R) ❑ CONDUCT (C) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ OTHER (0) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Increase per wage survey - payment effective 1/1/17; deferred until February payroll. SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE ENGINEER TECHNICIAN I OCCUPATION CODE 2425 UNION CODE 40 PAY GRADE 225 STEP / POSITION 7 FLSA STATUS ❑' Non -Exempt ❑ Exempt ❑ Not Covered Q Non -Exempt ❑ Exempt ❑ Not Covered DRS STATUS ❑ Ineligible 0 PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible ❑� PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 7/18/2016 ADJ HIRE DATE 7/18/2016 POSITION DATE 7/18/2016 LAST RAISE DATE BASE WAGE $ 3,417.00 $3,M- .00 LONGEVITY $ 0.00 $ FTE El 100% ❑ 80% ❑ 7s% ❑ 60% ❑ so% El l00% ❑ 80% ❑ 75% [:160% ❑ 50% FTE WAGE $ 3,417.00 $ 3,817.00 PAYMENT METHOD ❑ HOURLY ❑� MONTHLY ❑ HOURLY ❑� MONTHLY DEPARTMENT PUBLIC WORKS BUDGET NUMBER A. 000 RA3376 %: 100.00 B. %: A. B. %. WORKWEEK 0 Standard ❑ ALT/I" Friday off: El207(k) 2 Standard ❑ ALT/1`t Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $ 0.00 $ 0.00 STIPEND (Detail in Comments Section) $ 0.00 $ 0.00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4. SIGNATURES (MUST BE SIGNED IN BLUE INK) P R MENT EAD / ELECTED FFICIAt �I DATE BUDGET/P ROLL DATE �14f AN R U E U DATE tW/ COMMISSIDIIA T h� S 2 DATE COMMI [ DAl RETURN FORM TO HUMAN RESOURCES FOR DISTRMUTION Updated: 04/08/11 FOR HR USE: NT Update Eval Date EvalRating(IE— ID — S — AA — S) Initial C�\ KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) Updated: 04/08/11 FOR HR USE: NT Update Eval Date Eval Rating (IE—ID—S—AA—S) Initial 07 SECTION 1: EMPLOYEE DATA LAST NAME Huck FIRST NAME Lucas EMPLOYEE # H2696 EFFECTIVE DATE 01/01/2017 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ❑✓ FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT(7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE 19446R 7-sl6P ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) q TERMINATION (Provide Separation Info) ObTWER (Describe Below) ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ RETIRED (R) ❑ CONDUCT (C) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ OTHER (0) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS : Increase per wage survey - payment effective 01/01/17; deferred until February payroll. Interim stipend to continue until March 1st. SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE COUNTY ENGINEER OCCUPATION CODE 2377 UNION CODE 30 PAY GRADE 277 STEP / POSITION 6 FLSA STATUS ❑ Non -Exempt 0 Exempt ❑ Not Covered ❑ Non -Exempt Q Exempt ❑ Not Covered DRS STATUS ❑ Ineligible ❑ PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible ❑ PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 6/6/2016 ADJ HIRE DATE 6/6/2016 POSITION DATE 6/6/2016 LAST RAISE DATE I I f�} BASE WAGE $7,500.00 _ $8,339.00 LONGEVITY $ 0.00 $ FTE ❑' 100% [:180% ❑ 75% ❑ 60% ❑ 50% ❑' 100/ ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $ 7,500.00 $ 8,339.00 PAYMENT METHOD ❑ HOURLY ❑� MONTHLY ❑ HOURLY ❑� MONTHLY DEPARTMENT PUBLIC WORKS BUDGET NUMBER A. 000 RA3376 %: 100.00 B. %: A. %: B. %: WORKWEEK Q Standard ❑ ALT/1" Friday off: ❑ 207(k) 0 Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $ 0,00 $ 0.00 STIPEND (Detail in Comments Section) $ 500.00, OTHER (Detail in Comments Section) $ 0,00 $ 0.00 SECTION 4: SIGNATURES MUST BE SIGNED IN BLUE INK) DE TMENT HEAD / ELESXkD 'AOFFFIICIIA�L% �. DATE BUDGET/PAY LL y�7 fj D'A�T�E RES URLE 1 DATfE I r COMMI55 1 DATE [ I ❑ DATE COMMI R DA1 7 3 C� RETURN FORM TO HUMAN RESOURCES FOR DISTRIB ON Updated: 04/08/11 FOR HR USE: NT Update Eval Date Eval Rating (IE—ID—S—AA—S) Initial 07 Lew] LC_77':, KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) Updated: 04/08/11 FOR HR USE: NT Update Eval Date Eval Rating (IE—ID—S—AA—S) Initial SECTION 1: EMPLOYEE DATA LAST NAME Hoctor FIRST NAME Paula EMPLOYEE # K0187 EFFECTIVE DATE 01/01/2017 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ❑� FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE ❑ MERIT/ STEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ❑ TERMINATION (Provide Separation Info) 0 OTHER (Describe Below) ❑ DISCHARGE (D) ❑ RESIGNATION (Q) ❑ RETIRED (R) ❑ LAID OFF (L) ❑ FAIL PROBATION (P) ❑ OTHER (0) ❑ PERFORMANCE (P) ❑ ATTENDANCE (A) ❑ CONDUCT (C) ❑ OTHER EMPLOYMENT (E) ❑ PERSONAL (L) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire p Provide Details of Separation Below COMMENTS: Position's scale adjusted per BOCC and Sheriff, effective 1/1/17 SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE CORRECTIONS COMMANDER OCCUPATION CODE 1330 UNION CODE 30 PAY GRADE 130 STEP / POSITION 5 FLSA STATUS ❑ Non -Exempt El Exempt ❑ Not Covered ❑ Non -Exempt Exempt ❑ Not Covered DRS STATUS ❑ Ineligible ❑ PERS ❑ LEOFF a PSERS ❑ Other ❑ Ineligible ❑ PERS ❑ LEOFF I] PSERS ❑ Other HIRE DATE 7/20/1992 ADJ HIRE DATE 8/15/1992 POSITION DATE 1/1/2009 LAST RAISE DATE 1/1/2016 4 l BASE WAGE $ 5,601.00 $7;7-7 %V7 LONGEVITY $ 0.00 $ FTE ❑D 100% [:180% ❑ 75% ❑ 60% [:150% [j] 100% [:180% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $ 5,601.00 $ —71,'7 f. PAYMENT METHOD ❑ HOURLY ❑' MONTHLY ❑ HOURL ONTHLY DEPARTMENT SHERIFF BUDGET NUMBER A. 001 000000030010751001 %: 100.00 A. B. %: B. %: %: WORKWEEK To continue any allowance, stipend, El Standard ❑ ALT/1" Friday off: ❑ 207(k) 0 Standard ❑ ALT/1" Friday off: ❑ 207(k) or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $ 0.00 $ 0.00 STIPEND (Detail in Comments Section) $ 0.00 $ 0.00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES (MUST BE SIGNED IN BLUE INK) DEPARTMENT HEA /ELECTED qfIAL DATE BUDGET/ AYR L HU AN RE U CE DATE COM E DATE 13113 CO SSiO 2 TE CO M15Si DATIf RETURN FORM TO HUMAN RESOURCES FOR DISTft UTION Updated: 04/08/11 FOR HR USE: NT Update Eval Date Eval Rating (IE—ID—S—AA—S) Initial C1 KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) Updated: 04/08/11 FOR HR USE: NT Update EvalDate EvalRating(IE—ID—S—AA—S) Initial SECTION 1: EMPLOYEE DATA LAST NAME Dawson FIRST NAME Kim EMPLOYEE # D0137 EFFECTIVE DATE 01/01/2017 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE ❑ MERIT/ STEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ❑ TERMINATION (Provide Separation Info) ❑✓ OTHER (Describe Below) ❑ DISCHARGE (D) ❑ RESIGNATION (Q) ❑ RETIRED (R) ❑ LAID OFF (L) ❑ FAIL PROBATION (P) ❑ OTHER (0) ❑ PERFORMANCE (P) ❑ ATTENDANCE (A) ❑ CONDUCT (C) ❑ OTHER EMPLOYMENT (E) ❑ PERSONAL (L) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Position's scale adjusted per BOCC and Sheriff, effective 1/1/17. New title is Office Administrator, with new occupation code of 1313 and pay grade of 113. SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE ADMINISTRATIVE ASSISTANT III OFFICE ADMINSTRATOR OCCUPATION CODE 3376 1313 UNION CODE 30 30 PAY GRADE 376 113 STEP / POSITION 9 FLSA STATUS ❑ Non -Exempt [j] Exempt ❑ Not Covered ❑ Non -Exempt [j] Exempt ❑ Not Covered DRS STATUS ❑ Ineligible 0 PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible [D PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 11/1/1990 ADJ HIRE DATE 11/1/1990 POSITION DATE 1/1/2004 LAST RAISE DATE 1/1/2016 , BASE WAGE $4,371.00 5 I p$ LONGEVITY $ 0.00 $ FTE ❑� 100% ❑ 80% [:175% ❑ 60% ❑ 50% 100% ❑ 80% [:175% ❑60% ❑ 50% FTE WAGE $4,371.004 84$, _F01 09 PAYMENT METHOD ❑ HOURLY ❑� MONTHLY ❑ HOURLY 5ONTHLY DEPARTMENT SHERIFF BUDGET NUMBER A. 001 000000000300151001 %: 100.00 B. Yi: A. %: B. %: WORKWEEK 0 Standard ❑ ALT/1" Friday off: ❑ 207(k) 0 Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $ 0,00 $ 0.00 STIPEND (Detail in Comments Section) OTHER (Detail in Comments Section) $ 0.00 $ 0.00 $ 0.00 $ 0.00 SECTION 4: SIGNATURES (MUST BE SIGNED IN BLUE INK) DEPARTMENT HEAD D OFFIC L DATE z$'? -)-7 BUDGET/PAYROLL DATE H MAN RESOURCE DATE I #1 DATE CO i DATE 2-t J r l WW 31N1551S7#3 \ U E RETURN FORM TO HUMAN RESOURCES FOR DISTRIBU iON Updated: 04/08/11 FOR HR USE: NT Update EvalDate EvalRating(IE—ID—S—AA—S) Initial 12 KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) Updated: 04/08/11 FOR HR USE: NT Update Eval Date EvalRating(IE— ID — S — AA — S) Initial SECTION 1: EMPLOYEE DATA LAST NAME Higashiyama FIRST NAME Darren EMPLOYEE # H1158 EFFECTIVE DATE 01/01/2017 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ❑✓ FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE ❑ MERIT/ STEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ❑ TERMINATION (Provide Separation Info) ❑� OTHER (Describe Below) ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ RETIRED (R) ❑ CONDUCT (C) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ OTHER (0) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Positions scale adjusted Per BOCC and Sheriff, effective 1/1/17. SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE OPERATIONS COMMANDER OCCUPATION CODE 1315 30 UNION CODE PAY GRADE 115 STEP / POSITION 5 FLSA STATUS ❑ Non -Exempt Q Exempt ❑ Not Covered ❑ Non -Exempt 0 Exempt ❑ Not Covered DRS STATUS ❑ Ineligible ❑ PERS 0 LEOFF ❑ PSERS ❑ Other ❑ Ineligible ❑ PERS Q LEOFF ❑ PSERS ❑ Other HIRE DATE 12/19/1997 ADJ HIRE DATE 12/19/1997 POSITION DATE 4/1/2013 LAST RAISE DATE 1/1/2015 j BASE WAGE $ 5,574.00 -71. U -b LONGEVITY $ 0.00 $ FTE Q 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $5,574.00 $ 77- ' 71 , pv PAYMENT METHOD ❑ HOURLY Q MONTHLY ❑ HOURLY MONTHLY DEPARTMENT SHERIFF BUDGET NUMBER A. 001 000000000300151001 is 50.00 B. 001000000000003751001 %:50.00 A. B, is %: WORKWEEK Il Standard ❑ ALT/1" Friday off: ❑ 207(k) E] Standard ❑ ALT/1" Friday off: E1207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $ 0.00 $ 0.00 STIPEND (Detail in Comments Section) OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES (MUST BE SIGNED IN BLUE INK) DEPARTMENT HEAT] CTE DOfFICIAL DATE BUDGET YRO ��j� DATE HUM N ES RCE DATE COM / E C I R DATE ( CO O t - ,All C� /3 RETURN FORM T ) HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update Eval Date EvalRating(IE— ID — S — AA — S) Initial dt�� KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) Updated: 04/08/11 FOR HR USE: NT Update Eval Date Eval Rating (IE—ID—S—AA—S) Initial SECTION 1: EMPLOYEE DATA LAST NAME Myers FIRST NAME Clay EMPLOYEE # M0080 EFFECTIVE DATE 01/01/2017 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE ❑ MERIT/ STEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ❑ TERMINATION (Provide Separation Info) ❑✓ OTHER (Describe Below) ❑ DISCHARGE (D) ❑ RESIGNATION (Q) ❑ RETIRED (R) ❑ LAID OFF (L) ❑ FAIL PROBATION (P) ❑ OTHER (0) ❑ PERFORMANCE (P) ❑ ATTENDANCE (A) ❑ CONDUCT (C) ❑ OTHER EMPLOYMENT (E) ❑ PERSONAL (L) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Position's scale adjusted per BOCC and Sheriff, effective 1/1/17. SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE UNDERSHERIFF OCCUPATION CODE 1314 UNION CODE 30 PAY GRADE 114 STEP / POSITION 5 FLSA STATUS ❑ Non -Exempt [i] Exempt ❑ Not Covered ❑ Non -Exempt 0 Exempt ❑ Not Covered DRS STATUS ❑ Ineligible ❑ PERS [j] LEOFF ❑ PSERS ❑ Other ❑ Ineligible ❑ PERS LEOFF ❑ PSERS ❑ Other HIRE DATE 7/22/1985 ADJ HIRE DATE 7/22/1985 POSITION DATE 1/1/2004 LAST RAISE DATE 1/1/2016 I BASE WAGE $6,342.00$;'i LONGEVITY $ 0.00 $ FTE ❑� 100% ❑ 80% ❑ 75% ❑ 60% [:150% ❑� 100% ❑ 8o% ❑ 75% ❑ 60% [:150% FTE WAGE $6,342.00 $$-1 9.{'1 , ra PAYMENT METHOD ❑ HOURLY ❑' MONTHLY ❑ HOURLY 'MONTHLY DEPARTMENT SHERIFF BUDGET NUMBER A. 001 000000000300151001 %: 100.00 A. %; B. %: B. %: WORKWEEK [j] Standard ❑ ALT/1" Friday off: ❑ 207(k) 0 Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $ 0.00 $ 0,00 STIPEND (Detail in Comments Section) OTHER (Detail in Comments Section) $ 0.00 $ 0,00 SECTION 4: SIGNATURES (MUST BE SIGNED IN BLUE INK) DEPARTMENT HEADLELECTEDQEFtCiAL r► DATE I 7 " 2e� % BUDS AY %� DATE 4? o,> :211� f HU AN RESOURCE DTE CO I L1 .T C IS DTE COM1M ISSIOR • . DAATTE RETURN FORM TO HUMAN RESOURCES POR D53TRIBUTION Updated: 04/08/11 FOR HR USE: NT Update Eval Date Eval Rating (IE—ID—S—AA—S) Initial le�� KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) LAST NAME MacKenzie SECTION 1: EMPLOYEE DATA FIRST NAME EMPLOYEE # EFFECTIVE DATE Diana M0069 01/01/2017 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ❑✓ FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE ❑ MERIT/ STEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ❑ TERMINATION (Provide Separation Info) ❑✓ OTHER (Describe Below) ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ RETIRED (R) ❑ CONDUCT (C) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ OTHER (0) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Increase per wage survey - payment effective 1/1/17; deferred until February payroll. SECTION 3: POSITION DATA Enter exlsting data from CAMAS Wage Data Report Enter new data JOB TITLE DISTRICT COURT ADMIN OCCUPATION CODE 1310 UNION CODE 30 PAY GRADE 110 STEP /_POSITION 5 FLSA STATUS ❑ Non -Exempt Il Exempt ❑ Not Covered ❑ Non -Exempt 0 Exempt ❑ Not Covered DRS STATUS ❑ Ineligible 0 PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible Il PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 12/3/1984 ADJ HIRE DATE 12/3/1984 POSITION DATE 9/1/2010 LAST RAISE DATE 1/1/2016 BASE WAGE $4,377.00 $5,409.00 LONGEVITY $ 0.00 $ FTE ❑p 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% p 100% ❑ 80% ❑ 75% ❑ 60% [150% FTE WAGE $4,377.00 $5,409.00 PAYMENT METHOD ❑ HOURLY ❑� MONTHLY ❑ HOURLY 0 MONTHLY DEPARTMENT UPPER DISTRICT COURT BUDGET NUMBER A. 001 000000000003251001 %: 100.00 B. %: A. %: B. %: WORKWEEK Il Standard ❑ ALT/I" Friday off: ❑ 207(k) Il Standard ❑ ALT/I" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to '0". ALLOWANCE (Detail in Comments Section) $ 0.00 $ 0.00 STIPEND (Detail in Comments Section) $ 0.00 $ 0.00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES (MUST BE SIG IN BLUE INK) DEPARTMENT HEAD/ ELECTED OFFICIAL DATE BUDGET/ YROL DTE 4}MAN RESOURCE DATE COM R DATE C 2 DATf 1 4A. COM SIGN . f ATE .Z ETURNRFORM TO HESOUR0.1011 DISTRI TION Updated: 04/08/11 FOR HR USE: NT Update Eval Date Eva[ Rating (IE—ID—S—AA—S) Initial C_� KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) Updated: 04/08/11 FOR HR USE: NT Update Eval Date Eval Rating (IE—ID—S—AA—S) Initial SECTION 1: EMPLOYEE DATA LAST NAME Bloxham FIRST NAME EMPLOYEE # Christina B2659 EFFECTIVE DATE 12/01/2016 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ✓❑ FULL-TIME (1) ❑ PART-TIME (2) ❑LIMITE DPART-TI ME(3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE MERIT/ STEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ❑ TERMINATION (Provide Separation Info) ❑ OTHER (Describe Below) ❑ DISCHARGE (D) ❑ RESIGNATION (Q) RETIRED (R) ❑ LAID OFF (L) ❑ FAIL PROBATION (P) ❑ OTHER (0) ❑ PERFORMANCE (P) ❑ ATTENDANCE (A) ❑ CONDUCT (C) ❑ OTHER EMPLOYMENT (E) ❑ PERSONAL (L) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Employee annual evaluation has been completed. Effective date is 12/01/16 - Step 2 $3,700.; January 1, 2017 $3,811. SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE FISCAL ANALYST - PW OCCUPATION CODE 3213 UNION CODE 20 PAY GRADE 313 STEP / POSITION 1 2 FLSA STATUS ❑' Non -Exempt ❑ Exempt ❑ Not Covered ❑' Non -Exempt ❑ Exempt ❑ Not Covered DRS STATUS ❑ Ineligible PERS ❑LEOFF ❑ PSERS ❑ Other ❑ Ineligible OaPERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 12/14/2015 ADJ HIRE DATE 12/14/2015 POSITION DATE 12/14/2015 LAST RAISE DATE 12/01/2016 BASE WAGE $3,618.00 $3,811.00 LONGEVITY $ 0.00 $ FTE ❑' 100% [:180% ❑ 75% ❑ 60% ❑ 50% ❑' 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $ 3,618.00 $ 3,811.00 PAYMENT METHOD ❑ HOURLY ❑' MONTHLY ❑ HOURLY ❑' MONTHLY DEPARTMENT PUBLIC WORKS PUBLIC WORKS BUDGET NUMBER A. 000 RA3376 %: 100.00 B. 1W A. %: B. %: WORKWEEK 0 Standard ❑ ALT/1" Friday off: ❑ 207(k) 0 Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns foroudit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $ 0.00 $ 0.00 STIPEND (Detail in Comments Section) $ 0,00 $ 0.00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES MUST BE SIGNE i LUE INK) DEA TMENT HEAD / E TEF} OFFIC DATE ]BUDGETJpAY OLL PATE M RES RCE 4r DAT COMM1 DATE Co. R 2 DATE COMM N A RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update Eval Date Eval Rating (IE—ID—S—AA—S) Initial Q1 KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) Updated: 04/08/11 FOR HR USE: NT Update Eval Date EvalRating(IE— ID — S —AA — S) Initial SECTION 1: EMPLOYEE DATA LAST NAME Pless FIRST NAME Judy EMPLOYEE # P0022 EFFECTIVE DATE 01/01/2017 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ❑✓ FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT(7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE awwpsfep ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) P RMINATION (Provide Separation Info) HER (Describe Below) ❑ DISCHARGE (D) ❑ RESIGNATION (Q) ❑ RETIRED (R) ❑ LAID OFF (L) ❑ FAIL PROBATION (P) ❑ OTHER (0) ❑ PERFORMANCE (P) ❑ ATTENDANCE (A) ❑ CONDUCT (C) ❑ OTHER EMPLOYMENT (E) ❑ PERSONAL (L) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Increase per wage survey - payment effective 1/1/17; deferred until February payroll. SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE BUDGET & FINANCE MANAGER OCCUPATION CODE 2323 UNION CODE 30 PAY GRADE 223 STEP / POSITION 5 FLSA STATUS ❑ Non -Exempt El Exempt ❑ Not Covered ❑ Non -Exempt 0 Exempt ❑ Not Covered DRS STATUS ❑ Ineligible 0 PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible 2 PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 11/1/1976 ADJ HIRE DATE 11/1/1976 POSITION DATE 4/4/1990 LAST RAISE DATE 1/1/2016 01/01/2017 BASE WAGE $ 6,294.00 $ 6,923.00 LONGEVITY $ 85.00 $ 85.00 FTE ❑' 100% E]80% [:]75% E]60% [350% ❑' 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $ 6,294.00 $ 6,923.00 PAYMENT METHOD ❑ HOURLY ❑' MONTHLY ❑ HOURLY ❑' MONTHLY DEPARTMENT AUDITOR BUDGET NUMBER A. 001 000000000110251001 %: 100.00 A. %: B. %: B. %: WORKWEEK Q Standard ❑ ALT/I" Friday off: ❑ 207(k) I] Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to 10': ALLOWANCE (Detail in Comments Section) $ 0,00 $ 0.00 STIPEND (Detail in Comments Section) $25.00'J $ 25.00 J OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES (MUST BE SIGNED IN BLUE INK) DEP RTMENT 1 D / E E ED OFflAL)DATE 17 BUDGET/P RILL DA;E AN RESOURCE DATE CO 6�E4/,DATE R ATE COMR 0 ATE RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update Eval Date EvalRating(IE— ID — S —AA — S) Initial C -01-N KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) Updated: 04/08/11 FOR HR USE: NT Update Eval Date Eval Rating (IE–ID–S–AA–S) Initial SECTION 1: EMPLOYEE DATA LAST NAME Higginbotham FIRST NAME Sue EMPLOYEE # H0210 EFFECTIVE DATE 01/01/2017 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ❑� FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7)TERMINATION ❑ WORK STUDY (8) ElVOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE - Ah4ffi7-mP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) (Provide Separation Info) j�%all THEIR (Describe Below) ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ RETIRED (R) ❑ CONDUCT (C) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ OTHER (0) ❑ OTHER (0) F1Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Increase per wage survey - payment effective 1/1/17; deferred until February payroll. SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE ADMINISTRATIVE ASSISTANT III OCCUPATION CODE 3376 UNION CODE 30 PAY GRADE 376 STEP / POSITION 1 FLSA STATUS ❑ Non -Exempt ❑' Exempt ❑ Not Covered ❑ Non -Exempt ❑� Exempt ❑ Not Covered DRS STATUS ❑ Ineligible ❑� PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible ❑� PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 3/22/1993 ADJ HIRE DATE 3/22/1993 POSITION DATE 7/1/2008 LAST RAISE DATE 1/1/2016 01/01/2017 BASE WAGE $4,371.00 $4,808.00 LONGEVITY $ 0.00 $ FTE ❑� 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% ❑� 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $4,371.00 $4,808.00 PAYMENT METHOD ❑ HOURLY ❑� MONTHLY ❑ HOURLY ❑� MONTHLY DEPARTMENT AUDITOR BUDGET NUMBER A.001 000000000110151001 %: 100.00 B. %: A. %; B. %, WORKWEEK E] Standard ❑ ALT/1s` Friday off: ❑ 207(k) 0 Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to '0". ALLOWANCE (Detail in Comments Section) $, , � $ 0.00 STIPEND (Detail in Comments Section) $ 0.00 $ 25.00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES (MUST BE ED IN BLUE INK) DEP. TMENTI3 / D FICIAL ATE 8U ETJPAY OL ATE 60MAN RESOURCE DATECOM1vil DA L C OR p K2!� DTE C ATE 7 RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update Eval Date Eval Rating (IE–ID–S–AA–S) Initial `, KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) LAST NAME TOKARSYCK SECTION 1: EMPLOYEE DATA FIRST NAME EMPLOYEE # EFFECTIVE DATE MICHAEL T2752 02/13/17 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ❑ FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ® VOLUNTEER (9) ® NEW HIRE ❑ RE -HIRE ❑ MERIT/ STEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ❑ TERMINATION (Provide Separation Info) ❑ OTHER (Describe Below) ❑ DISCHARGE (D) ❑ RESIGNATION (Q) ❑ RETIRED (R) ❑ LAID OFF (L) ❑ FAIL PROBATION (P) ❑ OTHER (0) ❑ PERFORMANCE (P) ❑ ATTENDANCE (A) ❑ CONDUCT (C) ❑ OTHER EMPLOYMENT (E) ❑ PERSONAL (L) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Volunteer (Citizen Patrol) SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE VOLUNTEER/INTERN OCCUPATION CODE 9900 UNION CODE 90 PAY GRADE 900 STEP / POSITION I FLSA STATUS ❑ Non -Exempt ❑ Exempt ❑ Not Covered ❑ Non -Exempt ❑ Exempt ® Not Covered DRS STATUS ❑ Ineligible ❑ PERS ❑ LEOFF ❑ PSERS ❑ Other ® Ineligible ❑ PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 02/13/17 ADJ HIRE DATE 02/13/17 POSITION DATE 02/13/17 LAST RAISE DATE BASE WAGE $ $0 LONGEVITY $ $ FTE ❑ 100% ❑ 80% ❑ 75% ❑ 60%E]50% ® 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $ $0 PAYMENT METHOD ❑ HOURLY ❑ MONTHLY ❑ HOURLY JR] MONTHLY DEPARTMENT SHERIFF BUDGET NUMBER A. %- B. %: A. %.. B. WORKWEEK ❑ Standard ❑ ALT/1" Friday off: ❑ 207(k) ® Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $ $0 STIPEND (Detail in Comments Section) $ $0 OTHER (Detail in Comments Section) $ $0 SECTION 4: SIGNATURES (MUST BE SIGNED IN BLUE INK) DEPARTMENT HEAD / ELECTED OFFICIAL DATE x-7.17 BIJDGETjPAYROI I % DATE �f/��i Comm15 IF TE HUMA RESOURCE OM N DATE -DYFE ` L ` COMMISSIONERIt 4 D E O'er 'Y RETURN FORM TO HUMAN RESOURCES FOR —qTRIOUTION Updated: 04/08/11 FOR HR USE: NT Update Eval Date EvalRating(IE– ID – S – AA – S) Initial lam" KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) LAST NAME FINLEY SECTION 1: EMPLOYEE DATA FIRST NAME EMPLOYEE # EFFECTIVE DATE JON I F2753 02/13/17 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ RETIRED (R) ❑ CONDUCT (C) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ OTHER (0) ❑ OTHER (0) ❑ FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ® VOLUNTEER (9) ® NEW HIRE ❑ RE -HIRE ❑ MERIT/ STEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ❑ TERMINATION (Provide Separation Info) ❑ OTHER (Describe Below) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: VOLUNTEER (CITIZEN PATROL) SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE VOLUNTEER/INTERN OCCUPATION CODE 9900 UNION CODE 90 PAY GRADE 900 STEP / POSITION 1 FLSA STATUS ❑ Non -Exempt ❑ Exempt ❑ Not Covered ❑ Non -Exempt ❑ Exempt E Not Covered DRS STATUS ❑ Ineligible ❑ PERS ❑ LEOFF ❑ PSERS ❑ Other E Ineligible ❑ PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 02/13/17 ADJ HIRE DATE 02/13/17 POSITION DATE 02/13/17 LAST RAISE DATE BASE WAGE $ $0 LONGEVITY $ $ FTE ❑ 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% E 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $ $ PAYMENT METHOD ❑ HOURLY ❑ MONTHLY ❑ HOURLY WMONTHLY DEPARTMENT SHERIFF BUDGET NUMBER A. %: B. %: A. %: B. %: WORKWEEK ❑ Standard ❑ ALT/1" Friday off: ❑ 207(k) E Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to '0". ALLOWANCE (Detail in Comments Section) $ $0 STIPEND (Detail in Comments Section) $ $0 OTHER (Detail in Comments Section) $ $0 SECTION 4: SIGNATURES (MUST BE SIGN BLUE INK) DEPARTMENT HEAD / ELECTED OFFICIAL DATE s.-77-17 BUDGET/ P ROLL ATE fir HUMAN RES6URCE DATE COMM R ATE C 1 R % 11 DATE CO 10 Coll RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update Eval Date Eval Rating(IE— ID — S — AA — S) Initial U KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) LAST NAME IVIN SECTION 1: EMPLOYEE DATA FIRST NAME EMPLOYEE # EFFECTIVE DATE DIANE 112754 02/13/17 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ❑ FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) Z VOLUNTEER (9) ® NEW HIRE ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ RE -HIRE ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ MERIT/ STEP ❑ RETIRED (R) ❑ CONDUCT (C) ❑ POSITION CHANGE (Describe Below) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ BUDGET CHANGE (Describe Below) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ LEAVE (List Type Below) ❑ OTHER (0) ❑ OTHER (0) ❑ TERMINATION (Provide Separation Info) ❑ OTHER (Describe Below) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: VOLUNTEER (CITIZEN PATROL) SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE VOLLTNTEER/INTERN OCCUPATION CODE 9900 UNION CODE 90 PAY GRADE 900 STEP / POSITION I FLSA STATUS ❑ Non -Exempt ❑ Exempt ❑ Not Covered ❑ Non -Exempt ❑ Exempt Z Not Covered DRS STATUS ❑ Ineligible ❑ PERS ❑ LEOFF ❑ PSERS ❑ Other Z Ineligible ❑ PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 02/13/17 ADJ HIRE DATE 02/13/17 POSITION DATE 02/13/17 LAST RAISE DATE BASE WAGE $ $0 LONGEVITY $ $ FTE ❑ 100/ ❑ 80% ❑ 75% ❑ 60% ❑ 50% Z 100/ ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $ $ PAYMENT METHOD ❑ HOURLY ❑ MONTHLY ❑ HOURLY ()f MONTHLY DEPARTMENT SHERIFF BUDGET NUMBER A. %: B. %: A. %: B. %: WORKWEEK ❑ Standard ❑ ALT/I" Friday off: ❑ 207(k) Z Standard ❑ ALT/1'` Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $ $Q STIPEND (Detail in Comments Section) $ $0 OTHER (Detail in Comments Section) $ $Q SECTION 4: SIGNATURES (MUST BE SIGNED IN BLUE INK) DEPARTMENT HEAD / ELECTED OFFICIAL DATE BUDGETJPA OLL -7 // DATE HUMAN R . OURC£ DATE 1 1 COMMISSI 1 DA 'V C R # DATE COMM E [] E RETURN FORM Tb HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update EvalDate Eval Rating (IE—ID—S—AA—S) Initial U KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) Updated: 04/08/11 FOR HR USE: NT Update Eval Date Eval Rating (IE— ID—S—AA—S) Initial SECTION 1: EMPLOYEE DATA LAST NAME GANN FIRST NAME Sarah EMPLOYEE # G2721 EFFECTIVE DATE 02/21/17 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ® FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE ❑ MERIT/ STEP ❑ POSITION CHANGE (Describe Below) ® BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ❑ TERMINATION (Provide Separation Info) ❑ OTHER (Describe Below) ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ RETIRED (R) ❑ CONDUCT (C) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ OTHER (0) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Sarah Gann will be taking over the disability board duties that were formerly handled by Kim Nuffer (who has transferred to the Prosecutor's office). SECTION 3: POSITION DATA Enter existing datafrom CAMAS Wage Data Report Enter new data JOB TITLE U C r OCCUPATION CODE 4 �� UNION CODE PAY GRADE Cj STEP / POSITION FLSA STATUS Non -Exempt ❑ Exempt ❑ Not Covered Non -Exempt ❑ Exempt ❑ Not Covered DRS STATUS ❑ Ineligible 03PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible N PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 1E) ADJ HIRE DATE S 51 POSITION DATE LAST RAISE DATE BASE WAGE $ 3 $ LONGEVITY $ 0 $ FTE X 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% R 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $ M%3 $ PAYMENT METHOD ❑ HOURLY [% MONTHLY ❑ HOURLY [)fl MONTHLY DEPARTMENT CI I e, f 1<, BUDGET NUMBER A.0010000159951001 %: 100 B. r: A.001000159951001 %: 62 B. 00 100000 195 1001 %:38 WORKWEEK 5l Standard ❑ ALT/1" Friday off: ❑ 207(k) X Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $ 0 $ STIPEND (Detail in Comments Section) $ $ OTHER (Detail in Comments Section) $ (j $ SECTION 4: SIGNATURES (MUST BE SIGNED IN BLUE INK) DEPART HELECTED OFFIL) ,7 BUDGETjPY ,� /, HU AN RESOURCE DATE -7 1 COMltiRi O DATE COM=3—sle pAi :1le .00 C MI 11 DATE RETURN FORM TO HUMAN RESOURCES FOR DI IEiUTION. Updated: 04/08/11 FOR HR USE: NT Update Eval Date Eval Rating (IE— ID—S—AA—S) Initial KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) Updated: 04/08/11 FOR HR USE: NT Update Eval Date Eval Rating (IE — ID — S — AA — S) Initial SECTION 1: EMPLOYEE DATA LAST NAME Green FIRST NAME Kim EMPLOYEE # G1239 EFFECTIVE DATE 03/03/2017 EMPLOYEE TYPE SECTION 2: TYPE OF ACTION EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ❑✓ FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME(3) [:1 TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE ❑ MERIT/ STEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) Q TERMINATION (Provide Separation Info) ❑ OTHER (Describe Below) ❑ DISCHARGE (D) [E-RESIONATION (Q) Q ETIRED (R) LAID OFF (L) ❑ FAIL PROBATION (P) ❑ OTHER (0) ❑ PERFORMANCE (P) ❑ ATTENDANCE (A) ❑ CONDUCT (C) ❑ OTHER EMPLOYMENT (E) ❑ PERSONAL (L) ®' OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Effective 3/3/2017 Kim will be retiring from her position within the Auditor's Office. SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE RECORDS DEPUTY II OCCUPATION CODE 3218 UNION CODE 20 PAY GRADE 318 STEP / POSITION 7 FLSA STATUS [] Non -Exempt ❑ Exempt ❑ Not Covered ❑' Non -Exempt ❑ Exempt [:1 Not Covered DRS STATUS ❑ Ineligible [] PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible [PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 4/12/1999 ADJ HIRE DATE 4/12/1999 POSITION DATE 7/1/2001 LAST RAISE DATE 7/1/2011 BASE WAGE $-&,ee4-.00 $ 0.00 LONGEVITY $ 55.00 $ FTE [j] 100% ❑ 80% [:175% ❑ 6oi ❑ 5o% 0 l00% ❑ 80% ❑ 75% [160% ❑ 50% FTE WAGE $meg0 A $ PAYMENT METHOD ❑ HOURLY ❑� MONTHLY ❑ HOURLY ❑� MONTHLY DEPARTMENT AUDITOR BUDGET NUMBER A.001 000000000110351001 is 100.00 A. %: B. %: A. %: WORKWEEK ❑' Standard ❑ ALT/1" Friday off: E1207(k) [] Standard ❑ ALT/1" Friday off: E3207(k) To continue any allowance, stipend, or other, it must be listed in both columns foraudit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) U -3-k— $ 0.00 STIPEND (Detail in Comments Section) $ 0.00 $ 0.00 OTHER (Detail in Comments Section) [$0.00 $ 0.00 SECTION 4: SIGNATURES MUST BE SIGNED IN BLUE INK DEP TMENTHEA I ELEC D 1CI y A I Eo 1� ,04 BUDGET RY 1. DATE J"' 3;/1 MAN R SOURCE ( ATE COMMIS.S pA ME�/_ �T! K_N2 ATE tE COMM TE RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update Eval Date Eval Rating (IE — ID — S — AA — S) Initial . KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) Updated: 04/08/11 FOR HR USE: NT Update Eval Date Eval Rating (IE -ID -S -AA -S) Initial SECTION 1: EMPLOYEE DATA LAST NAME Larson FIRST NAME Chad EMPLOYEE # L2667 EFFECTIVE DATE 01/01/2017 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ❑� FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE ❑ MERIT/ STEP ❑ POSITION CHANGE (Describe Below) ❑✓ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ❑ TERMINATION (Provide Separation Info) ❑ OTHER (Describe Below) ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ RETIRED (R) ❑ CONDUCT (C) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ OTHER (0) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Budget change due to Assessor's salary survey results. Changing budget allocation from 50% General Fund / 50% REET to 43% General Fund / 57% REET, SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE APPRAISER I OCCUPATION CODE 2159 UNION CODE 10 PAY GRADE 259 STEP / POSITION 1 FLSA STATUS ❑� Non -Exempt ❑ Exempt ❑ Not Covered 0 Non -Exempt ❑ Exempt ❑ Not Covered DRS STATUS ❑ Ineligible ❑ PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible ❑ PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 2/2/2016 ADJ HIRE DATE 2/2/2016 POSITION DATE 2/2/2016 LAST RAISE DATE BASE WAGE $3,746.00 $0.00 LONGEVITY $ 0.00 $ FTE 0 100% ❑ 80% [:175% ❑ 60% ❑ 50% ❑� 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $ 3,746.00 $ PAYMENT METHOD ❑ HOURLY ❑� MONTHLY ❑ HOURLY 0 MONTHLY DEPARTMENT ASSESSOR BUDGET NUMBER A. 142 000000000001451001 %: 50.00 B. 001000000000001051001 %:50.00 A. 142 1451001 %: 57 B. 0011051001 %:43 WORKWEEK 0 Standard ❑ ALT/1" Friday off: ❑ 207(k) El Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) I $ 0.00 $ 0.00 STIPEND (Detail in Comments Section) [$0.00 $ 0.00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SE l N 4: SIGNATURES (MUST BE SIGNED LUE INK) DEP E T O/ELECTEDQFFI .A lu DATE BUDGE TjPAY LL DA E J! 12 U JAAAU RESOURCE DATE COMN1155 ki DATE i7h?in C N 7 (DATE COMM ! / TATE RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update Eval Date Eval Rating (IE -ID -S -AA -S) Initial r-. KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) LAST NAME Harwood _SECTION 1: EMPLOYEE DATA FIRST NAME EMPLOYEE # EFFECTIVE DATE Shannon H1601 1-1-17 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE FULL-TIME (1) — ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ❑ NEW HIRE ❑ RE -HIRE ❑ MERIT/ STEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ❑ TERMINATION (Provide Separation Info) °� OTHER (Describe Below) ❑ DISCHARGE (D) ❑ RESIGNATION (Q) ❑ RETIRED (R) ❑ LAID OFF (L) ❑ FAIL PROBATION (P) ❑ OTHER (0) ❑ PERFORMANCE (P) ❑ ATTENDANCE (A) ❑ CONDUCT (C) ❑ OTHER EMPLOYMENT (E) ❑ PERSONAL (L) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: y Q 1 Ati7Jv1 PIL +D TvY✓, P&v�'� 1.1— 9 (� SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE Crime Victim Specialist OCCUPATION CODE 2453 UNION CODE 40 PAY GRADE 253 STEP / POSITION 5 ® Non -Exempt [_-]Exempt ❑Not Covered FLSA STATUS ❑ Non -Exempt ❑ Exempt ❑ Not Covered DRS STATUS ❑ Ineligible ® PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible ❑ PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 5-17-04 ADJ HIRE DATE 5-17-04 POSITION DATE 8-9-04 LAST RAISE DATE 1-1-16 1-1-17 BASE WAGE $3770 $4147. LONGEVITY $0 $ FTE ® 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% ❑ 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $3770 $4147 PAYMENT METHOD ❑ HOURLY ® MONTHLY ❑ HOURLY ❑ MONTHLY DEPARTMENT Prosecutor BUDGET NUMBER A.13O51OO1 %:70 B. 130290551001 %:30 A. %: B. %: WORKWEEK ®Standard ❑ALT/V Friday off: ❑ 207(k) ❑Standard ❑ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $ $ STIPEND (Detail in Comments Section) $ $ OTHER (Detail in Comments Section) $ $ SE 4: SIGNATURES (MUST BE SIGNED IN BLUE TN K) DEP ME EAD / EtECTF 1CIAL ^� ' DATE BUD.GETIP 04? T' HUM 116- M7 /,A: !' DATE V-7 CO SS ONE DAT CO M R 2 CO ATf RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update Eval Date EvalRating(IE- ID -S -AA -S) Initial GA- LAST NAME Larson KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) SECTION 1: EMPLOYEE DATA FIRST NAME EMPLOYEE # EFFECTIVE DATE Chad I L2667 �' SECTION 2: TYPE OF ACTION 4_1 !-1 EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ❑✓ FULL-TIME (1) ❑ NEW HIRE ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ PART-TIME (2) ❑ RE -HIRE ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ LIMITED PART-TIME (3) MERIT / STEP ❑ RETIRED (R) ❑ CONDUCT (C) ❑ TEMPORARY (4) ❑ POSITION CHANGE (Describe Below) ❑• LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ CASUAL (5) ❑ BUDGET CHANGE (Describe Below) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ SEASONAL (6) ❑ LEAVE (List Type Below) ❑ OTHER (0) ❑ OTHER (0) ❑ PROJECT (7) ❑ TERMINATION (Provide Separation Info) 02/02/2017 LAST RAISE DATE ❑ WORK STUDY (8) ❑ OTHER (Describe Below) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below ❑ VOLUNTEER (9) COMMENTS: CHAD IS MOVING TO APPRAISER II, STEP 1 UPON SUCCESSFUL COMPLETION OF REQUIREMENTS; DATE OF ACCREDITATION 02/02/2017 SECTION 3: POSITION DATA BASE WAGE $ 3,746.00 $ 3,936.00 LONGEVITY $ 0.00 $ 0 FTE 0 100% ❑ 80% ❑ 75% [:160% ❑50% 0 100% [:180% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $ 3,746.00 $ 3,936.00 PAYMENT METHOD ❑ HOURLY ❑• MONTHLY ❑ HOURLY Q MONTHLY DEPARTMENT ASSESSOR BUDGET NUMBER A. 142 000000000001451001 %: 50.00 A %: B. 001 000000000001051001 %: 50.00 g, [dC�� �..�A,�� %: WORKWEEK E Standard ❑ ALT/1" Friday off: ❑ 207(k) Q Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $ 0,00 $ 0,00 STIPEND (Detail in Comments Section) $ 0.00 $ 0,00 OTHER (Detail in Comments Section) $ 0,00 $ 0,00 SECTION 4: SIGNATURES (MUST BE SIGN BLUE INK) DEPA %iNIENT HEAD /.ELECTED OFF1 AL DATE BUDGE�PA OLL DATE HUMA RESOURCE / DATE I COMVISS"Eflff HATE �I!��'�� 7L�ila /��it�J•!i=1f��• _r�� �T� ��1aI1l�i Updated: 04/08/11 FOR HR USE: NT Update Eval Date EvalRating(IE–ID–S–AA–S) Initial Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE APPRAISER I APPRAISER II OCCUPATION CODE 2159 2166 UNION CODE 10 to PAY GRADE 259 266 STEP / POSITION 1 FLSA STATUS E• Non -Exempt ❑ Exempt ❑ Not Covered ❑• Nan -Exempt ❑ Exempt ❑ Not Covered DRS STATUS ❑ Ineligible N PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ IneligibleZ PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 2/2/2016 ADJ HIRE DATE 2/2/2016 POSITION DATE 2/2/2016 02/02/2017 LAST RAISE DATE 02/02/201 BASE WAGE $ 3,746.00 $ 3,936.00 LONGEVITY $ 0.00 $ 0 FTE 0 100% ❑ 80% ❑ 75% [:160% ❑50% 0 100% [:180% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $ 3,746.00 $ 3,936.00 PAYMENT METHOD ❑ HOURLY ❑• MONTHLY ❑ HOURLY Q MONTHLY DEPARTMENT ASSESSOR BUDGET NUMBER A. 142 000000000001451001 %: 50.00 A %: B. 001 000000000001051001 %: 50.00 g, [dC�� �..�A,�� %: WORKWEEK E Standard ❑ ALT/1" Friday off: ❑ 207(k) Q Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $ 0,00 $ 0,00 STIPEND (Detail in Comments Section) $ 0.00 $ 0,00 OTHER (Detail in Comments Section) $ 0,00 $ 0,00 SECTION 4: SIGNATURES (MUST BE SIGN BLUE INK) DEPA %iNIENT HEAD /.ELECTED OFF1 AL DATE BUDGE�PA OLL DATE HUMA RESOURCE / DATE I COMVISS"Eflff HATE �I!��'�� 7L�ila /��it�J•!i=1f��• _r�� �T� ��1aI1l�i Updated: 04/08/11 FOR HR USE: NT Update Eval Date EvalRating(IE–ID–S–AA–S) Initial J KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) LAST NAME Ihrke SECTION 1: EMPLOYEE DATA FIRST NAME EMPLOYEE # EFFECTIVE DATE Joel 12666 _T 01/19/2017 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ❑✓ FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE ❑✓ MERIT/ STEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ❑ TERMINATION (Provide Separation Info) ❑ OTHER (Describe Below) ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ RETIRED (R) ❑ CONDUCT (C) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ OTHER (0) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: JOEL IS MOVING TO APPRAISER II, STEP 1 UPON SUCCESSFUL COMPLETION OF REQUIREMENTS; DATE OF ACCREDITATION 01/19/2017 SECTION 3: POSITION DATA Enter existing data from CAMAS Woge Data Report Enter new data JOB TITLE APPRAISER I APPRAISER II OCCUPATION CODE 2159 2166 UNION CODE 10 10 PAY GRADE 259 266 STEP / POSITION 1 FLSA STATUS 0 Non -Exempt ❑ Exempt ❑ Not Covered ❑� Non -Exempt ❑ Exempt ❑ Not Covered DRS STATUS ❑ Ineligible N PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 1/19/2016 ADJ HIRE DATE 1/19/2016 POSITION DATE 1/19/2016 01/19/2017 LAST RAISE DATE 01/19/201% BASE WAGE $ 3,746.00 $ 3,936.00 LONGEVITY $ 0.00 $ 0 FTE El00% ❑ 80% ❑ 75% [-]60% ❑ 50% E100% ❑ 80% ❑ 75r ❑ 60% C-150% FTE WAGE $ 3,746.00 $ 3,936.00 PAYMENT METHOD ❑ HOURLY ❑� MONTHLY ❑ HOURLY ❑� MONTHLY DEPARTMENT ASSESSOR B U DG ET N U M B E R A. 001 000000000001051001 %: 100.00 B. %: A. %: B. %: WORKWEEK Q Standard ❑ ALT/1" Friday off: ❑ 207(k) ❑� Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $ 0.00 $ 0.00 STIPEND (Detail in Comments Section) $ 0.00 $ 0.00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES (MUST BE SIGN N BLUE INK) DEP rH EAD j El EGTE D F C L DATE cy SUI]GET/P . RDLL% 'TE HCWARESOURCE v-V�^"W DATE COMM1 TE of C LZI DATE -` 3 3- -CO 10 D 3 RETURN FORM TO HUMAN RESOURCES FOR DISTRiBUTIO Updated: 04/08/11 FOR HR USE: NT Update Eval Date Eval Rating (IE - ID - S - AA - S) Initial KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) Updated: 04/08/11 FOR HR USE: NT Update Eval Date Eval Rating (IE—ID—S—AA—S) Initial SECTION 1: EMPLOYEE DATA _ LAST NAME Young FIRST NAME Lisa EMPLOYEE # Y1270 EFFECTIVE DATE 01/01/2017 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ✓❑ FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE ❑ MERIT/ STEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ❑ TERMINATION (Provide Separation Info) ❑✓ OTHER (Describe Below) 1 ❑ DISCHARGE (D) ❑ RESIGNATION (Q) ❑ RETIRED (R) ❑ LAID OFF (L) ❑ FAIL PROBATION (P) ❑ OTHER (0) ❑ PERFORMANCE (P) ❑ ATTENDANCE (A) ❑ CONDUCT (C) ❑ OTHER EMPLOYMENT (E) ❑ PERSONAL (L) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Wage survey implementation -deferred from January 1, 2017 VW\;t) du_�-,Z AlLwavite, 4 up SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE HUMAN RESOURCE DIRECTOR 1350 OCCUPATION CODE UNION CODE 30 PAY GRADE 150 STEP / POSITION 5 FLSA STATUS ❑ Non -Exempt ❑� Exempt ❑ Not Covered ❑ Non -Exempt II Exempt ❑ Not Covered DRS STATUS ❑ Ineligible E PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible Q PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 7/7/1999 ADJ HIRE DATE 7/7/1999 POSITION DATE 11/8/2010 LAST RAISE DATE 1/1/2016 01/01/2017 BASE WAGE $ 5,663.00 $ 6,150.00 LONGEVITY $ 0.00 $ FTE p 100% ❑ 80% [:175 % ❑ 60% ❑ 50% Q 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $ 5,663.00 $ 6,150.00 PAYMENT METHOD ❑ HOURLY ❑� MONTHLY ❑ HOURLY ❑' MONTHLY DEPARTMENT HUMAN RESOURCE BUDGET NUMBER A. 001 000000000380151001 %: 100.00 B. %: A. %: B. %: WORKWEEK [D Standard ❑ ALT/1" Friday off: ❑ 207(k) 0 Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $ 60,00 $ 60.00 STIPEND (Detail in Comments Section) $ 0,00 $ 0.00 OTHER (Detail in Comments Section) $ 0,00 $ 0.00 SECTION 4: SIGNATURES IMUST BE SIGNED tN BLUE INK) DEP T D / EL ED OFFICIAL DATE BUDGETIP ROLL DATE H RE . D COMMi I DTE CO ISS IlyDATE CONI N DATF RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update Eval Date Eval Rating (IE—ID—S—AA—S) Initial KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) LAST NAME Goeben SECTION 1: EMPLOYEE DATA FIRST NAME EMPLOYEE # EFFECTIVE DATE Jim G1446 01/01/2017 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ✓❑ FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE ❑ MERIT/ STEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ❑ TERMINATION (Provide Separation Info) ❑✓ OTHER (Describe Below) ❑ DISCHARGE (D) ❑ RESIGNATION (Q) ❑ RETIRED (R) ❑ LAID OFF (L) ❑ FAIL PROBATION (P) ❑ OTHER (0) ❑ PERFORMANCE (P) ❑ ATTENDANCE (A) ❑ CONDUCT (C) ❑ OTHER EMPLOYMENT (E) ❑ PERSONAL (L) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Wage survey implementation - deferred from January 1, 2017 SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE IT DIRECTOR OCCUPATION CODE 1309 UNION CODE 30 PAY GRADE 109 STEP / POSITION 5 FLSA STATUS ❑ Non -Exempt [j] Exempt ❑ Not Covered ❑ Non -Exempt Exempt ❑ Not Covered DRS STATUS ❑ Ineligible ❑� PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible ❑� PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 2/4/2002 ADJ HIRE DATE 2/4/2002 POSITION DATE 2/14/2012 LAST RAISE DATE 1/1/2016 1/1/17 BASE WAGE $ 5,877.00 $ 6,250.00 LONGEVITY $ 0.00 $ FTE Q 100% ❑ 80% ❑ 75% ❑ 60%E]50% ❑� 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $ 5,877.00 $ 6,250.00 PAYMENT METHOD ❑ HOURLY ❑� MONTHLY []HOURLY MONTHLY DEPARTMENT INFORMATION TECHNOLOGY BUDGET NUMBER A. 001 000000000001751001 %: 100.00 B. %: A. %: B. % WORKWEEK [fl Standard ❑ ALT/1" Friday off: ❑ 207(k) E Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $ 60.00 $ 60.00 STIPEND (Detail in Comments Section) $ 0.00 $ 0.00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES (MUST BE SIGNS L SLUE INK) DEP EAD/ ECTEDOFFICIAL DATE 7 BUDGET/P ACLL DATE ANIRMURCE CIAT 1�12!�, COMMI DATE CAM fON D T CO 5 L__� � T`E; � 2—` \,3, RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update Eval Date Eval Rating (IE—ID—S—AA—S) Initial tt% KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) LAST NAME Nuffer SECTION 1: EMPLOYEE DATA FIRST NAME EMPLOYEE # EFFECTIVE DATE Kim N1908 02/17/2017 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ® FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT(7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE ❑ MERIT/STEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) %TERMINATION (Provide Separation Info) ❑ OTHER (Describe Below) ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑✓ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ RETIRED (R) ❑ CONDUCT (C) ❑ LAID OFF (L) ❑✓ OTHER EMPLOYMENT (E) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ OTHER (0) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS. SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE DEPUTY CLERK OCCUPATION CODE 3245 UNION CODE 20 PAY GRADE 345 STEP / POSITION 7 FLSA STATUS Q Non -Exempt ❑ Exempt ❑ Not Covered Q Non -Exempt ❑ Exempt ❑ Not Covered DRSSTATUS Ineligible Q PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible ❑ PERS ❑ LEOFF ❑ PSERS ❑Other HIRE DATE 12/11/2006 ADJ HIRE DATE 12/11/2006 POSITION DATE 12/11/2006 LAST RAISE DATE 12/1/2012 BASE WAGE $ 3,304.00 $ 0.00 LONGEVITY $45.00 $ FTE Q 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% [j] 100/ ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $3,304.00 $ PAYMENT METHOD ❑ HOURLY ❑� MONTHLY ❑ HOURLY F MONTHLY DEPARTMENT CLERK BUDGET NUMBER A.001 000000000159951001 %: 62.00 B. 001 000000000001951001 %: 38.00 A. B. i s WORKWEEK F Standard ❑ ALT/1" Friday off: E1207(k) E Standard ❑ ALT/1" Friday off: E1207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $ 0.00 $ 0.00 STIPEND (Detail in Comments Section) $ 0.00 $ 0.00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES (MUST BE SIGNED IN BLUE INK) UFPAH THE / ELECTED FICIAL DAT 17 BUDGET/PAYk ATF COMMISSIO 3 DATF HUMAN RESOURCE DAT C I It DATE COMMIS 1r l7 E RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update Eval Date Eval Rating (IE — ID — S — AA — S) Initial C� KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) Updated: 04/08/11 FOR HR USE: NT Update Eval Date EvalRating(IE—ID—S—AA—S) Initial SECTION 1: EMPLOYEE DATA LAST NAME Casey FIRST NAME EMPLOYEE # EFFECTIVE DATE Hollie C2469 1/1/2017 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ❑✓ FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE ❑ MERIT/ STEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ❑ TERMINATION (Provide Separation Info) OTHER (Describe Below) ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ RETIRED (R) ❑ CONDUCT (C) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ OTHER (0) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Increase per wage survey -payment effective 1/1/17; deferred until February payroll. SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE PUBLIC HEALTH TECHNICIAN OCCUPATION CODE 3412 UNION CODE 40 PAY GRADE 312 STEP / POSITION 6 FLSA STATUS Non -Exempt [:]Exempt ❑ Not Covered ❑� Non -Exempt ❑ Exempt ❑ Not Covered DRS STATUS ❑ Ineligible ❑0 PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible ❑� PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 8/17/2015 ADJ HIRE DATE 8/17/2015 POSITION DATE 8/17/2015 LAST RAISE DATE it 14 BASE WAGE $ 2,946.00 $ 3, 83.00,/' LONGEVITY $ 0.00 $ FTE ❑' 100% [180% ❑ 75% [:160% ❑50% 100% [:180% ❑ 75% ❑ 60%E150% FTE WAGE $ 2,946.00 $ 3,583.00 PAYMENT METHOD ❑ HOURLY ❑� MONTHLY ❑ HOURLY ❑' MONTHLY DEPARTMENT PUBLIC HEALTH BUDGET NUMBER A. 116 000000000061151001 %: 100.00 B. %: A. %: B. %: WORKWEEK 2 Standard ❑ ALT/1" Friday off: ❑ 207(k) I ❑' Standard ❑ ALT/1' Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0'', ALLOWANCE (Detail in Comments Section) $ 0.00 $ 0.00 STIPEND (Detail in Comments Section) $ 0.00 $ 0.00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES (MUST BE SIGNED IN BLUE INK) D i EL`T O FICIAL DATE BUUGET/PAYRO s �D/ATf I I HUAIN RESOURCE OA E COMMI NER DATE MM R 2' DATE L. V CO SSiO . ` A " RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update Eval Date EvalRating(IE—ID—S—AA—S) Initial C+ _ KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) LAST NAME Blackford SECTION 1: EMPLOYEE DATA FIRST NAME EMPLOYEE # EFFECTIVE DATE Candi B2058 1/1/2017 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ❑� FULL-TIME (1) ❑ NEW HIRE ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ PART-TIME (2) ❑ RE -HIRE ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ LIMITED PART-TIME (3) ❑ MERIT/ STEP ❑ RETIRED (R) ❑ CONDUCT (C) ❑ TEMPORARY (4) ❑ POSITION CHANGE (Describe Below) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ CASUAL (5) ❑ BUDGET CHANGE (Describe Below) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ SEASONAL (6) ❑ LEAVE (List Type Below) ❑ OTHER (0) ❑ OTHER (0) ❑ PROJECT (7) ❑ TERMINATION (Provide Separation Info) ❑ WORK STUDY (8) OTHER (Describe Below) ❑ Eligible For Rehire ❑ Ineligible For Rehire ❑ VOLUNTEER (9) Provide Details of Separation Below COMMENTS: Increase per wage survey -payment effective 1/1/17; deferred until February payroll. SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE ADMINSTRATIVE SUPERVISOR OCCUPATION CODE 3349 UNION CODE 30 PAY GRADE 349 STEP / POSITION 5 FLSA STATUS ❑ Non -Exempt Ij Exempt ❑ Not Covered ❑ Non -Exempt 0 Exempt ❑ Not Covered DRS STATUS ❑ Ineligible 0 PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible Q PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 3/10/2008 ADJ HIRE DATE 3/10/2008 POSITION DATE 7/13/2015 LAST RAISE DATE 1/1/2015 BASE WAGE $ 3,692.00 $ 3,877.00 LONGEVITY $ 0.00 { $ FTE ❑� 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% ❑' 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $ 3,692.00 $ 3,877.00 PAYMENT METHOD ❑ HOURLY ❑� MONTHLY ❑ HOURLY ❑� MONTHLY DEPARTMENT PUBLIC HEALTH BUDGET NUMBER A. 116 000000000061151001 %: 100.00 B. %: A. %: B. %: WORKWEEK Q Standard ❑ ALT/1" Friday off: ❑ 207(k) M Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $ 0.00 $ 0.00 STIPEND (Detail in Comments Section) $ 0.00 $ 0.00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES (MUST BE SIGNET] UE INK) M EAb•/.ELE D OFFICIAL DATE BUDGET/PAYR LL ' AT, HUMAN RESOURCE DATECOMMI5 p ATE C E 2 DATE tor® LOM N6HPS' DAT151 RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated 04/08/11 FOR HR USE: NT Update EvalDate EvalRating(IE—ID—S—AA—S) Initial �� rt� KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) SECTION 1: EMPLOYEE DATA LAST NAME Lamb FIRST NAME Tristen EMPLOYEE # EFFECTIVE DATE L2550 01/01/2017 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION j TYPE OF SEPARATION REASON FOR SEPARATION ❑r FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE ❑ MERIT / STEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ❑ TERMINATION (Provide Separation Info) OTHER (Describe Below) ❑ DISCHARGE (D) ❑ RESIGNATION (Q) ❑ RETIRED (R) ❑ LAID OFF (L) ❑ FAIL PROBATION (P) ❑ OTHER (0) ❑ PERFORMANCE (P) ❑ ATTENDANCE (A) ❑ CONDUCT (C) ❑ OTHER EMPLOYMENT (E) ❑ PERSONAL (L) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Increase per wage survey -payment effective 1/1/17; deferred until February payroll. SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE HEALTH PROMOTION SPECIALIST I OCCUPATION CODE 2433 UNION CODE 40 PAY GRADE 233 STEP / POSITION 6 FLSA STATUS Il Non -Exempt ❑ Exempt ❑ Not Covered 0 Non -Exempt ❑ Exempt ❑ Not Covered DRS STATUS ❑ Ineligible ❑� PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible Q PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 9/4/2014 ADJ HIRE DATE 9/4/2014 POSITION DATE 6/20/2016 LAST RAISE DATE l BASE WAGE $ 3,563.00 $ 3,741.00 LONGEVITY $ 0.00 $ FTE 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $ 3,563.00 $ 3,741.00 PAYMENT METHOD ❑ HOURLY ❑� MONTHLY ❑ HOURLY ❑' MONTHLY DEPARTMENT PUBLIC HEALTH BUDGET NUMBER A. 116 000000006121151001 %: 100.00 B. %: A. %: B. %: WORKWEEK ❑' Standard ❑ ALT/1" Friday off: ❑ 207(k) ❑� Standard ❑ ALT/1' Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $ 0,00 $ 0.00 STIPEND (Detail in Comments Section) $ 0.00 $ 0.00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES (MUST BE SIGNED IN BLUE INK) D TME F EAD /ELECT D OFFICIAL DATE !91111- 7 BUDGET/ TE H M N RESOURCE DATECOM DVE C O E DME 2-1 CO N DATE RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update Eval Date EvalRating(IE—ID—S—AA—S) Initial C_� KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) Updated: 04/08/11 FOR HR USE: NT Update Eval Date Eval Rating (IE—ID—S—AA—S) Initial SECTION 1: EMPLOYEE DATA LAST NAME Stratis FIRST NAME Rebecca EMPLOYEE # S2727 EFFECTIVE DATE 01/01/2017 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ❑� FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE ❑ MERIT/ STEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ❑ TERMINATION (Provide Separation Info) OTHER (Describe Below) ❑ DISCHARGE (D) ❑ RESIGNATION (Q) ❑ RETIRED (R) ❑ LAID OFF (L) ❑ FAIL PROBATION (P) ❑ OTHER (0) ❑ PERFORMANCE (P) ❑ ATTENDANCE (A) ❑ CONDUCT (C) ❑ OTHER EMPLOYMENT (E) ❑ PERSONAL (L) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire 1 Provide Details of Separation Below COMMENTS: Increase per wage survey -payment effective 1/1/17; deferred until February payroll. SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE ENVIRONMENTAL HEALTH SPECIALIST I OCCUPATION CODE 2439 UNION CODE 40 PAY GRADE 239 STEP / POSITION 7 FLSA STATUS ❑' Non -Exempt ❑ Exempt ❑ Not Covered Non -Exempt [:]Exempt ❑ Not Covered DRS STATUS ❑ Ineligible E PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible Il PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 9/12/2016 ADJ HIRE DATE 9/12/2016 POSITION DATE 9/12/2016 LAST RAISE DATE BASE WAGE $ 3,403.00 $ 3,583.00 LONGEVITY $ 0.00 $ FTE ❑p 100% [:180% ❑ 75% ❑ 60% ❑ 50% ❑p 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $ 3,403.00 $ 3,583.00 PAYMENT METHOD ❑ HOURLY ❑� MONTHLY ❑ HOURLY ❑' MONTHLY DEPARTMENT PUBLIC HEALTH BUDGET NUMBER A.116 000000000061551001 %: 100.00 B. %: A. %: B. %: WORKWEEK ❑' Standard ❑ ALT/1" Friday off: ❑ 207(k) ❑' Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $ 0.00 $ 0.00 STIPEND (Detail in Comments Section) $ 0.00 $ 0.00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES (MUST BE SIGNED IN BLUE INK) D TMEN EAD / ED OFFICIAL 1 DATE BUDGETJPAY . LL�L� � DATE � HQMAN RESOURCE DATE r� COMMI ONE TE L M I R R2 DATE 2 �3 CCs N DATE RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update Eval Date Eval Rating (IE—ID—S—AA—S) Initial j KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) LAST NAME Whitaker SECTION 1: EMPLOYEE DATA FIRST NAME EMPLOYEE # EFFECTIVE DATE Liz W1482 01/01/2017 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ❑Q FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE ❑ MERIT/ STEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ❑ TERMINATION (Provide Separation Info) ❑r OTHER (Describe Below) ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ RETIRED (R) ❑ CONDUCT (C) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ OTHER (0) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS Increase per wage survey - payment effective 1/1/17; deferred until February payroll. SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE COMMUNITY HEALTH SPVR OCCUPATION CODE 2393 UNION CODE 30 PAY GRADE 293 STEP / POSITION 1 FLSA STATUS ❑ Non -Exempt ❑� Exempt ❑ Not Covered ❑ Non -Exempt ❑' Exempt ❑ Not Covered DRS STATUS ❑ Ineligible ❑� PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible ❑' PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 9/10/2012 ADJ HIRE DATE 9/10/2012 POSITION DATE 9/10/2012 LAST RAISE DATE 1/1/2016 l 1 BASE WAGE $ 5,253.00 $ 5,673.00 LONGEVITY $ 0.00 $ FTE ❑� 100% ❑ 80% ❑ 75% ❑ 60% [150% ❑� 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $ 5,253.00 $ 5,673.00 PAYMENT METHOD ❑ HOURLY ❑� MONTHLY ❑ HOURLY ❑' MONTHLY DEPARTMENT PUBLIC HEALTH BUDGET NUMBER A. 116 000000000061251001 %: 100.00 B. %: A. %: B. %: WORKWEEK ❑' Standard ❑ ALT/1" Friday off: ❑ 207(k) ❑� Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $ 0,00 $ 0.00 STIPEND (Detail in Comments Section) $ 0.00 $ 0.00 OTHER (Detail In Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES (MUST BE SIGNED IN BLUE INK) DE T#AENTIREY{�� E OF ICTAL L� + I 1 DATE 14 BUDGET/PAY LL ATE 'fes MAN RESOURCE DATE COM I DATE CO 4 • ATE 02- -13 C DATE 2.1 t-15- RETURN FORM TO HUMAN RESOURCES FOR nicTiaftyfioN Updated: 04/08/11 FOR HR USE: NT Update Eval Date EvalRating(IE—ID—S—AA—S) Initial LAST NAME Odiaga KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) SECTION 1: EMPLOYEE DATA FIRST NAME EMPLOYEE # FEFFECTIVE DATE Katie 02722 01 /E(01/2017 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION V[I ULL-TI ME (1) ❑ PART-TIME (2) ❑ NEW HIRE ❑ RE -HIRE ❑ DISCHARGE (D) ❑ RESIGNATION (Q) ❑ PERFORMANCE (P) ❑ ATTENDANCE (A) ❑ LIMITED PART-TIME (3) ❑ MERIT/ STEP ❑ RETIRED (R) ❑ CONDUCT (C) ❑ TEMPORARY (4) ❑ POSITION CHANGE (Describe Below) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ CASUAL (5) ❑ BUDGET CHANGE (Describe Below) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ SEASONAL (6) ❑ LEAVE (List Type Below) ❑ OTHER (0) ❑ OTHER (0) ❑ PROJECT (7) ❑ TERMINATION (Provide Separation Info) ADJ HIRE DATE 8/15/2016 ❑ Eligible For Rehire ❑ Ineligible For Rehire ❑ WORK STUDY (8) OTHER (Describe Below) i Provide Details of Separation Below ❑ VOLUNTEER (9) COMMENTS: Increase per wage survey -payment effective 1/1/17; deferred until February payroll. SFCTION a! POSITION DATA To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will aefoult to "u". ALLOWANCE (Detail in Comments Section) $ 0.00 $ 0.00 STIPEND (Detail in Comments Section) $ 0.00 $ 0.00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES (MUST BE SIGNED IN BLUE INK) HUMAN RESOURCE DATE Ca-, I 111, �--� �L I2 �= RETURN FORM TO HUMAN RESOURCES FOR DIS' Updated: 04/08/11 FOR HR USE: NT Update Eva[ Date ATE Eval Rating (IE—ID—S—AA—S) Initial Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE PUBLIC HEALTH TECHNICIAN OCCUPATION CODE 3412 UNION CODE 40 PAY GRADE 312 STEP / POSITION 1 FLSA STATUS ❑' Non -Exempt ❑ Exempt ❑ Not Covered ❑� Non -Exempt ❑ Exempt ❑ Not Covered DRS STATUS ❑ Ineligible ❑ PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible ❑ PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 8/15/2016 ADJ HIRE DATE 8/15/2016 POSITION DATE 8/15/2016 LAST RAISE DATE I BASE WAGE $ 2,946.00 $ 3,583.00 LONGEVITY $ 0.00 $ FTE ❑O 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% [j] 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $ 2,946.00 $ 3,583.00 PAYMENT METHOD ❑ HOURLY ❑� MONTHLY ❑ HOURLY ❑' MONTHLY DEPARTMENT PUBLIC HEALTH BUDGET NUMBER A. 116 000000000061151001 %.: 100.00 B. 56t A. %: B. %: WORKWEEK E] Standard ❑ ALT/1A Friday off: ❑ 207(k) ❑ Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will aefoult to "u". ALLOWANCE (Detail in Comments Section) $ 0.00 $ 0.00 STIPEND (Detail in Comments Section) $ 0.00 $ 0.00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES (MUST BE SIGNED IN BLUE INK) HUMAN RESOURCE DATE Ca-, I 111, �--� �L I2 �= RETURN FORM TO HUMAN RESOURCES FOR DIS' Updated: 04/08/11 FOR HR USE: NT Update Eva[ Date ATE Eval Rating (IE—ID—S—AA—S) Initial KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) Updated: 04/08/11 FOR HR USE: NT Update Eval Date EvalRating(IE—ID—S—AA—S) Initial SECTION 1: EMPLOYEE DATA LAST NAME Roth f FIRST NAME I Tim EMPLOYEE # R1167 EFFECTIVE DATE 01/01/2017 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ❑✓ FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE ❑ MERIT/ STEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ❑ TERMINATION (Provide Separation Info) 'I�L?THER (Describe Below) ❑ DISCHARGE (D) ❑ RESIGNATION (Q) ❑ RETIRED (R) ❑ LAID OFF (L) ❑ FAIL PROBATION (P) ❑ OTHER (0) ❑ PERFORMANCE (P) ❑ ATTENDANCE (A) ❑ CONDUCT (C) ❑ OTHER EMPLOYMENT (E) ❑ PERSONAL (L) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire 1 Provide Details of Separation Below COMMENTS: Increase per wage survey -payment effective 1/1/17; deferred until February payroll. SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE PUBLIC HEALTH NURSE II OCCUPATION CODE 2471 UNION CODE 40 PAY GRADE 271 STEP / POSITION 6 FLSA STATUS it Non -Exempt ❑ Exempt ❑ Not Covered El Non -Exempt ❑ Exempt ❑ Not Covered DRS STATUS ❑ Ineligible ❑' PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible ❑' PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 6/22/2015 ADJ HIRE DATE 7/13/2015 POSITION DATE 6/22/2015 LAST RAISE DATE 1/1/2016 4 } BASE WAGE $4,151.00 $ 4,381.00 LONGEVITY $ 0.00 $ FTE ❑� 100% [:180% ❑ 75% ❑ 60%E150% ❑� 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $ 4,151.00 $ 4,381.00 PAYMENT METHOD ❑ HOURLY ❑� MONTHLY ❑ HOURLY (j] MONTHLY DEPARTMENT PUBLIC HEALTH BUDGET NUMBER A. 116 000000000061251001 %: 100.00 B. %: A. %: B. %: WORKWEEK ❑� Standard ❑ ALT/1" Friday off: ❑ 207(k) El Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $ 0,00 $ 0,00 STIPEND (Detail in Comments Section) $ 0.00 $ 0,00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES (MUST BE SIGNED IN BLUE INK) DE > ►� _.N Q/ ELECTS Ff1CIAL DATE BUDGETIPAYROCL (lf-��7DATE HU AN RESOURCE CO IS5 # DATECOMMf551 �� aATE ql DAT COMMS RETURN FORM TOM)MAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update Eval Date EvalRating(IE—ID—S—AA—S) Initial C-� KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) Updated: 04/08/11 FOR HR USE: NT Update Eval Date Eval Rating (IE—ID—S—AA—S) Initial SECTION 1: EMPLOYEE DATA LAST NAME Schaan FIRST NAME Joann EMPLOYEE # S2703 EFFECTIVE DATE 01/01/2017 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION *FULL -Ti ME (1) 5jCPART-TIME (2) LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE ❑ MERIT/ STEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ❑ TERMINATION (Provide Separation Info) OTHER (Describe Below) ❑ DISCHARGE (D) ❑ RESIGNATION (Q) ❑ RETIRED (R) ❑ LAID OFF (L) ❑ FAIL PROBATION (P) ❑ OTHER (0) ❑ PERFORMANCE (P) ❑ ATTENDANCE (A) ❑ CONDUCT (C) ❑ OTHER EMPLOYMENT (E) ❑ PERSONAL (L) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Increase per wage survey -payment effective 1/1/17; deferred until February payroll. SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Repoli Enter new data JOB TITLE DD PROGRAM COORDINATOR OCCUPATION CODE 2874 UNION CODE 40 PAY GRADE 274 STEP / POSITION 15 FLSA STATUS I] Non -Exempt ❑ Exempt [:]Not Covered ❑� Non -Exempt ❑ Exempt ❑ Not Covered DRS STATUS ❑ Ineligible ❑ PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible ❑ PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 6/7/2016 ADJ HIRE DATE 6/7/2016 POSITION DATE 6/7/2016 LAST RAISE DATE j BASE WAGE $ 2,041.80 $ 2,237.40 LONGEVITY $ 0.00 $ FTE ❑ 100% [:180% ❑ 75% ❑� 60% ❑ 50% ❑ 100% ❑ 80% ❑ 75% Q 60% ❑ 50% FTE WAGE $ 3,403.00 $ 3,729.00 PAYMENT METHOD ❑ HOURLY ❑� MONTHLY ❑ HOURLY ❑' MONTHLY DEPARTMENT PUBLIC HEALTH BUDGET NUMBER A. 105 000000000056851001 %: 100.00 B. %: A. %: B. %: WORKWEEK El Standard ❑ ALT/1" Friday off: ❑ 207(k) El Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $ 0.00 $ 0.00 STIPEND (Detail in Comments Section) $ 0.00 $ 0.00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES (MUST BE SIGNED IN BLUE INK) DEP T LHEAEV-ELECJED OFFICIAL DATE BUDGET/ P Ot DATE H MAN RESOURCE -1 I' ATE 1� COMMI # D E 6 0 C DATE n L t , COMMS E IIATE RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update Eval Date Eval Rating (IE—ID—S—AA—S) Initial C1, KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) Updated: 04/08/11 FOR HR USE: NT Update Eval Date EvalRating(IE-ID-S-AA-S) Initial SECTION 1: EMPLOYEE DATA LAST NAME Schumaier FIRST NAME Melissa EMPLOYEE # S1595 EFFECTIVE DATE 01/01/2017 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION j TYPE OF SEPARATION REASON FOR SEPARATION ULL-TIME (1) WP RT -TIME (2) IMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE ❑ MERIT/ STEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ❑ TERMINATION (Provide Separation Info) Q OTHER (Describe Below) ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ RETIRED (R) ❑ CONDUCT (C) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ OTHER (0) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Increase per wage survey -payment effective 1/1/17; deferred until February payroll. SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE ENVIRONMENTAL HEALTH SPEC 2 OCCUPATION CODE 12472 UNION CODE 140 PAY GRADE 1 272 STEP / POSITION 16 FLSA STATUS 0 Non -Exempt ❑ Exempt ❑ Not Covered El Non -Exempt ❑ Exempt ❑ Not Covered DRS STATUS [3 Ineligible E] PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible [j] PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 12/5/2005 ADJ HIRE DATE 12/5/2005 POSITION DATE 12/5/2005 LAST RAISE DATE 1/1/2016 BASE WAGE $ 2,802.60 $ 082.80 LONGEVITY $ 0.00 $ FTE ❑ 100% ❑ 80% ❑ 75% [j] 60% ❑ 50% ❑ 100% ❑ 80% ❑ 75% 60% ❑ 50% FTE WAGE $ 4,671.00 $ 5,138.00 PAYMENT METHOD ❑ HOURLY 0 MONTHLY ❑ HOURLY 0 MONTHLY DEPARTMENT PUBLIC HEALTH BUDGET NUMBER A. 116 000000000061551001 %: 100.00 B. %: A. %: B. %: WORKWEEK 2 Standard ❑ ALT/1st Friday off: ❑ 207(k) El Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0", ALLOWANCE (Detail in Comments Section) $ 0.00 $ 0.00 STIPEND (Detail in Comments Section) $ 0.00 $ 0.00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES (MUST SIGNM IN BLUE INK D TMENT -/-El: 9V-$fd�IAL - L DATE BUOG /PAYRO kTE AN RESOURCEDATE COMMISS DAT CO lit DATE COM N TE J RETURN FORiN ro mumAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update Eval Date EvalRating(IE-ID-S-AA-S) Initial C� KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) LAST NAME Sarver SECTION 1: EMPLOYEE DATA FIRST NAME EMPLOYEE # EFFECTIVE DATE Kimberly S2708 01/01/2017 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION Q FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE ❑ MERIT/ STEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ❑ TERMINATION (Provide Separation Info) ❑✓ OTHER (Describe Below) ❑ DISCHARGE (D) ❑ RESIGNATION (Q) ❑ RETIRED (R) ❑ LAID OFF (L) ❑ FAIL PROBATION (P) ❑ OTHER (0) ❑ PERFORMANCE (P) ❑ ATTENDANCE (A) ❑ CONDUCT (C) ❑ OTHER EMPLOYMENT (E) ❑ PERSONAL (L) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Increase per wage survey -payment effective 1/1/17; deferred until February payroll. SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE ENVIRONMENTAL HEALTH SPECIALIST I OCCUPATION CODE 2439 UNION CODE 40 PAY GRADE 239 STEP / POSITION 5 FLSA STATUS 111 Non -Exempt ❑ Exempt ❑ Not Covered Q Non -Exempt ❑ Exempt ❑ Not Covered DRS STATUS ❑ Ineligible ❑ PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible ❑ PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 6/27/2016 ADJ HIRE DATE 6/27/2016 POSITION DATE 6/27/2016 LAST RAISE DATE I 1 BASE WAGE $ 3,403.00 $ 3,583.00 LONGEVITY $ 0.00 $ FTE ❑� 100% ❑ 80% [:175% ❑ 60% [:150% ❑O 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $ 3,403.00 $ 3,583.00 PAYMENT METHOD ❑ HOURLY ❑' MONTHLY ❑ HOURLY ❑' MONTHLY DEPARTMENT PUBLIC HEALTH BUDGET NUMBER A. 116 000000006150351001 %: 100.00 S. %: A. %: B. %: WORKWEEK ❑� Standard ❑ ALT/1" Friday off: ❑ 207(k) ❑� Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $ 0.00 $ 0.00 STIPEND (Detail in Comments Section) $ 0.00 $ 0.00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES (MUST BE SIGNED IN BLUE INK) EN'EECDFICIAL DATE I BUDGET/PAYR LL - DTEDE 14�% H MAN REsdTJRC6 DATE COMMISSI DA E COMM{ ATE CO Q%� DATE RETURN FORM TO HUMAN RESOURCES FOR DISTRIBOTION Updated 04/08/11 FOR HR USE: NT Update Eval Date EvalRating(IE—ID—S—AA—S) Initial KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) LAST NAME Schwab SECTION 1: EMPLOYEE DATA FIRST NAME EMPLOYEE # EFFECTIVE DATE Will S2652 01/01/2017 SECTION 2: TYPE OF ACTION l EMPLOYEE TYPE EMPLOYEE ACTION 1 TYPE OF SEPARATION REASON FOR SEPARATION ✓❑ FULL-TIME (1) ❑ NEW HIRE ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ PART-TIME (2) ❑ RE -HIRE ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ LIMITED PART-TIME (3) ❑ MERIT/ STEP ❑ RETIRED (R) ❑ CONDUCT (C) ❑ TEMPORARY (4) ❑ POSITION CHANGE (Describe Below) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ CASUAL (5) ❑ BUDGET CHANGE (Describe Below) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ SEASONAL (6) ❑ LEAVE (List Type Below) ❑ OTHER (0) ❑ OTHER (0) ❑ PROJECT (7) ❑ TERMINATION (Provide Separation Info) ❑ WORK STUDY (8) Q OTHER (Describe Below) ❑ Eligible For Rehire ❑ Ineligible For Rehire ❑ VOLUNTEER (9) Provide Details of Separation Below COMMENTS: Increase per wage survey -payment effective 1/1/17; deferred until February payroll. SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE ENVIRONMENTAL HEALTH SPECIALIST I OCCUPATION CODE 2439 40 UNION CODE PAY GRADE 239 STEP / POSITION 5 FLSA STATUS ❑� Non -Exempt ❑ Exempt ❑ Not Covered El Non -Exempt ❑ Exempt ❑ Not Covered DRS STATUS ❑ Ineligible ❑ PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible ❑ PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 10/26/2015 ADJ HIRE DATE 10/26/2015 POSITION DATE 7/25/2016 LAST RAISE DATE 12/1/2015 l I BASE WAGE $ 3,403.00 $ 3,583.00 LONGEVITY $ 0.00 $ FTE 0 100% ❑ 80% ❑ 75% ❑ 60% [150% ❑� 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $ 3,403.00 $ 3,583.00 PAYMENT METHOD ❑ HOURLY ❑� MONTHLY ❑ HOURLY ❑' MONTHLY DEPARTMENT PUBLIC HEALTH BUDGET NUMBER A.116 000000000061551001 %: 100.00 B. %: A. %: B. %: WORKWEEK ❑� Standard ❑ ALT/1°` Friday off: ❑ 207(k) ❑' Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $ 0,00 $ 0.00 STIPEND (Detail in Comments Section) $ 0.00 $ 0.00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES (MUST BE SIGNED IN BLUE INK) D TMENT CTEDOFFICIAL I DATE BUDGET/PAY LL ATE HyIMAN RESOURCE DATE COMMI551 # __PA3E PAM pF2 DATE c COMtrtl ❑ ' c � RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update Eval Date Eval Rating (IE—ID—S—AA—S) Initial Ma KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) Updated: 04/08/11 FOR HR USE: NT Update Eval Date Eval Rating (IE—ID—S—AA—S) Initial SECTION 1: EMPLOYEE DATA LAST NAME Karns FIRST NAME Julia EMPLOYEE # K1323 EFFECTIVE DATE 01/01/2017 EMPLOYEE TYPE SECTION 2: TYPE OF ACTION EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION FULL-TIME (1) ❑ NEW HIRE ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ PART-TIME (2) ❑ RE -HIRE ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ LIMITED PART-TIME (3) ❑ MERIT/ STEP ❑ RETIRED (R) ❑ CONDUCT (C) ❑ TEMPORARY (4) ❑ POSITION CHANGE (Describe Below) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ CASUAL (5) ❑ BUDGET CHANGE (Describe Below) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ SEASONAL (6) ❑ LEAVE (List Type Below) ❑ OTHER (0) ❑ OTHER (0) ❑ PROJECT (7) ❑ TERMINATION (Provide Separation Info) ❑ WORK STUDY (8) OTHER (Describe Below) ❑ Eligible For Rehire ❑ Ineligible For Rehire ❑ VOLUNTEER (9) Provide Details of Separation Below COMMENTS: Increase per wage survey -payment effective 1/1/17; deferred until February payroll. SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE COMMUNITY HEALTH SPEC I OCCUPATION CODE 2454 UNION CODE 40 PAY GRADE 254 STEP / POSITION 5 FLSA STATUS 0 Non -Exempt ❑ Exempt ❑ Not Covered Q Non -Exempt ❑ Exempt ❑ Not Covered DRS STATUS ❑ Ineligible IE PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible M PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 6/5/2000 ADJ HIRE DATE 6/5/2000 POSITION DATE 1/1/2014 LAST RAISE DATE 1/1/2016 l , BASE WAGE $ 3,510.00 $ 3,729.00 LONGEVITY $ 0.00 $ FTE ❑E 100% [180% ❑75% ❑ 60% ❑ 50% ❑� 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $ 3,510.00 $ 3,729.00 PAYMENT METHOD ❑ HOURLY ❑� MONTHLY ❑ HOURLY MONTHLY DEPARTMENT PUBLIC HEALTH BUDGET NUMBER A.116 000000000061251001 %: 100.00 A. %: B. %; B. %: WORKWEEK ❑� Standard ❑ ALT/1" Friday off: ❑ 207(k) ❑� Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $ 0.00 $ 0.00 STIPEND (Detail in Comments Section) $ 0.00 $ 0.00 OTHER (Detail in Comments Section) $ 0,00 $ 0.00 SECTION 4: SIGNATURES (MUST BE SIGNED IN BLUE INK) O RTME ADLJLECTED OFFICIAL r C} DATE ) BUDGETIP DTE :•`. HILIMANRESOURCE DATE COMMI ff DATE COMM E M 2 6ATE RETURN FORM TO ESOU RM FOR DiSTRIO"ON Updated: 04/08/11 FOR HR USE: NT Update Eval Date Eval Rating (IE—ID—S—AA—S) Initial CD KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) Updated: 04/08/11 FOR HR USE: NT Update Eval Date EvalRating(IE—ID—S—AA—S) Initial SECTION 1: EMPLOYEE DATA l LAST NAME Knutson FIRST NAME EMPLOYEE # EFFECTIVE DATE Kasey K2121 01/01/2017 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION Q FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE ❑ MERIT/ STEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ❑ TERMINATION (Provide Separation Info) ❑✓ OTHER (Describe Below) ❑ DISCHARGE (D) ❑ RESIGNATION (Q) ❑ RETIRED (R) ❑ LAID OFF (L) ❑ FAIL PROBATION (P) ❑ OTHER (0) ❑ PERFORMANCE (P) ❑ ATTENDANCE (A) ❑ CONDUCT (C) ❑ OTHER EMPLOYMENT (E) ❑ PERSONAL (L) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Increase per wage survey -payment effective 1/1/17; deferred until February payroll. SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE HEALTH PROMOTION SUPERVISOR OCCUPATION CODE 2356 UNION CODE 30 PAY GRADE 256 STEP / POSITION 5 FLSA STATUS ❑ Non -Exempt El Exempt ❑ Not Covered ❑ Non -Exempt El Exempt ❑ Not Covered DRS STATUS ❑ Ineligible 0 PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible 2 PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 10/1/2008 ADJ HIRE DATE 10/1/2008 POSITION DATE 1/19/2015 LAST RAISE DATE 1/1/2016 - / BASE WAGE $4,311.00 $4, 91.00'/ LONGEVITY $ 0.00 $ FTE ❑Q 100% [180% ❑75% [:160% ❑50% 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $4,311.00 $4,891.00 PAYMENT METHOD ❑ HOURLY ❑� MONTHLY ❑ HOURLY ❑Q MONTHLY DEPARTMENT PUBLIC HEALTH BUDGET NUMBER A. 116 000000006121151001 %: 100.00 B. %: A. %: B. %: WORKWEEK E] Standard ❑ ALT/1" Friday off: ❑ 207(k) E] Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $ 0.00 $ 0.00 STIPEND (Detail in Comments Section) $ 0.00 $ 0.00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES (MUST BE SIGNED IN BLUE INK) DEP DOFFICIAL DATE BUDGET/PAYROLL DATE - . 11. HU AN RESOURCE DATE COMMISS R 1 CIATE C g &airCOMtvFI DATEf aold__ _L_ RETURN FORM TO HUMAN RESOURCES FOR DISTRIBU ON Updated: 04/08/11 FOR HR USE: NT Update Eval Date EvalRating(IE—ID—S—AA—S) Initial C-,� KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) Updated: 04/08/11 FOR HR USE: NT Update Eval Date Eval Rating (IE—ID—S—AA—S) Initial SECTION 1: EMPLOYEE DATA LAST NAME Larson FIRST NAME Mark EMPLOYEE # L1866 EFFECTIVE DATE 01/01/2017 SECTION 2: TYPE OF ACTION _ EMPLOYEE TYPE EMPLOYEE ACTION I TYPE OF SEPARATION REASON FOR SEPARATION ❑ FULL-TIME (1) ❑� PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE ❑ MERIT/ STEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ❑ TERMINATION (Provide Separation Info) OTHER (Describe Below) ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ RETIRED (R) ❑ CONDUCT (C) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ OTHER (0) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Increase per wage survey -payment effective 1/1/17; deferred until February payroll. SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE OCCUPATION CODE HEALTH OFFICER 1351 UNION CODE 32 PAY GRADE 151 STEP / POSITION 1 FLSA STATUS ❑ Non -Exempt [:]Exempt ❑ Not Covered ❑ Non -Exempt ❑ Exempt ❑ Not Covered DRS STATUS E Ineligible ❑ PERS ❑ LEOFF ❑ PSERS ❑ Other ❑� Ineligible ❑ PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 7/1/2006 ADJ HIRE DATE 7/1/2006 POSITION DATE 7/1/2006 LAST RAISE DATE 1/1/2016 BASE WAGE $ 2,941.60 $ 3,276.00 LONGEVITY $ 0.00 $ FTE ❑ 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% ❑ 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $14,708.00 $ 0.00 l b s o PAYMENT METHOD ❑ HOURLY Q MONTHLY ❑ HOURLY ❑' MONTHLY DEPARTMENT PUBLIC HEALTH BUDGET NUMBER A. 116 000000000061551011 %: 50.00 A. %: B. 116 000000000061251011 %: 25.00 B. %: WORKWEEK Standard ❑ ALT/1" Friday off: ❑ 207(k) '❑ Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $ 0.00 $ 0.00 STIPEND (Detail in Comments Section) $ 0.00 $ 0.00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES (MUST BE SIGNED IN BLUE INK) AL �)-[ ( ZMM= DATE I l BUDGET/P RUt DATE 2I,l. HUMAN RESOURCE DATE C r] / COMMIS DA TE ryR DATE COM Oid t RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update Eval Date Eval Rating (IE—ID—S—AA—S) Initial C-1 KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) Updated: 04/08/11 FOR HR USE: NT Update Eval Date EvalRating(IE—ID—S—AA—S) Initial SECTION 1: EMPLOYEE DATA LAST NAME Moore FIRST NAME Erin EMPLOYEE # A2074 EFFECTIVE DATE 01/01/2017 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ❑ FULL-TIME (1) ❑ NEW HIRE ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑� PART-TIME (2) ❑ RE -HIRE ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ LIMITED PART-TIME (3) ❑ MERIT/ STEP ❑ RETIRED (R) ❑ CONDUCT (C) ❑ TEMPORARY (4) ❑ POSITION CHANGE (Describe Below) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ CASUAL (5) ❑ BUDGET CHANGE (Describe Below) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ SEASONAL (6) ❑ LEAVE (List Type Below) ❑ OTHER (0) ❑ OTHER (0) ❑ PROJECT (7) ❑ TERMINATION (Provide Separation Info) ❑ WORK STUDY (8) OTHER (Describe Below) ❑ Eligible For Rehire ❑ Ineligible For Rehire ❑ VOLUNTEER (9) _ Provide Details of Separation Below COMMENTS: Increase per wage survey -payment effective 1/1/17; deferred until February payroll. SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE ENVIRONMENTAL HEALTH SPEC 2 OCCUPATION CODE 2472 UNION CODE 40 PAY GRADE 272 STEP / POSITION 5 FLSA STATUS Non -Exempt ❑ Exempt ❑ Not Covered 19 Non -Exempt ❑ Exempt [:]Not Covered DRS STATUS ❑ Ineligible ❑' PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible Q PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 5/19/2008 ADJ HIRE DATE 15/19/2008 POSITION DATE 1/1/2016 LAST RAISE DATE 1/1/2016 BASE WAGE $ 2,150.40 $ 2,332.20 LONGEVITY $ 0.00 $ FTE [:1100% ❑ 80% ❑ 75% ❑� 60% ❑ 50% ❑ 100% ❑ 80% ❑ 75% ❑D 60% [150% FTE WAGE $ 3,584.00 $ 3,887.00 PAYMENT METHOD ❑ HOURLY ❑� MONTHLY ❑ HOURLY ❑� MONTHLY DEPARTMENT PUBLIC HEALTH BUDGET NUMBER A. 116 000000000061551001 %: 100.00 A. %: B. %: B. %: WORKWEEK j E] Standard ❑ ALT/1n Friday off: ❑ 207(k) ❑� Standard ❑ ALT/1Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $ 0,00 $ 0.00 STIPEND (Detail in Comments Section) $ 0.00 $ 0.00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECrION 4: SIGNATURES (MUST BE SIGNED IN BLUE INK) DEP ENTHi / f Ef}OFF! IAL DATE BUDGET/ Y A1T4 _2 l- ] HU N R OURCE DATE COMMISSS 1 DAT CO ER DATE 2.�1 �1 • COML}15 D � � � 3- � RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update Eval Date EvalRating(IE—ID—S—AA—S) Initial �S KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) LAST NAME Myers SECTION 1: EMPLOYEE DATA FIRST NAME EMPLOYEE # EFFECTIVE DATE Holly M2030 01/01/2017 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE ❑ MERIT / STEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ❑ TERMINATION (Provide Separation Info) ❑✓ OTHER (Describe Below) ❑ DISCHARGE (D) ❑ RESIGNATION (Q) ❑ RETIRED (R) ❑ LAID OFF (L) ❑ FAIL PROBATION (P) ❑ OTHER (0) ❑ PERFORMANCE (P) ❑ ATTENDANCE (A) ❑ CONDUCT (C) ❑ OTHER EMPLOYMENT (E) ❑ PERSONAL (L) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Increase per wage survey -payment effective 1/1/17; deferred until February payroll. SECTION 3: POSITION DATA Enter existing data from C4 MAS Wage Data Report Enter new data JOB TITLE ENVIRONMENTAL HEALTH SPVR OCCUPATION CODE 2394 UNION CODE 30 PAY GRADE 294 STEP / POSITION 5 FLSA STATUS ❑ Non -Exempt ❑' Exempt ❑ Not Covered ❑ Non -Exempt ❑E Exempt ❑ Not Covered DRS STATUS ❑ Ineligible 0 PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible 0 PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 9/23/2013 ADJ HIRE DATE 9/23/2013 POSITION DATE 9/23/2013 LAST RAISE DATE 1/1/2016 .I BASE WAGE $ 5,393.00 $ 5,797.00' LONGEVITY $ 0.00 $ FTE ❑' 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% ❑� 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $ 5,393.00 $ 5,797.00 PAYMENT METHOD ❑ HOURLY ❑� MONTHLY ❑ HOURLY ❑� MONTHLY DEPARTMENT PUBLIC HEALTH BUDGET NUMBER A. 116 000000000061551001 %: 100.00 B. %: A. B. 46: WORKWEEK [j] Standard ❑ ALT/1" Friday off: ❑ 207(k) 0 Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $ 0,00 $ 0.00 STIPEND (Detail in Comments Section) $ 0.00 $ 0.00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES (MUST BE SIGNED IN BLUE INK) DEP TME HEAD -f-6 CTED OFFICIAL DATE BUDGET ' YROL / ATE HU AN RESOURCE C M g DATE COM DA DATE1 COM I ATE % Z, ` RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update EvalDate EvalRating(IE—ID—S—AA—S) Initial KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) Updated: 04/08/11 FOR HR USE: NT Update Eval Date Eval Rating (IE—ID—S—AA—S) Initial SECTION 1: EMPLOYEE DATA LAST NAME FIRST NAME EMPLOYEE # EFFECTIVE DATE Fuller Amy F2397 1/1/2017 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ❑✓ FULL-TIME (1) ❑ NEW HIRE ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ PART-TIME (2) ❑ RE -HIRE ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ LIMITED PART-TIME (3) ❑ MERIT / STEP ❑ RETIRED (R) ❑ CONDUCT (C) ❑ TEMPORARY (4) ❑ POSITION CHANGE (Describe Below) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ CASUAL (5) ❑ BUDGET CHANGE (Describe Below) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ SEASONAL (6) ❑ LEAVE (List Type Below) ❑ OTHER (0) ❑ OTHER (0) ❑ PROJECT (7) ❑ TERMINATION (Provide Separation Info) ❑ WORK STUDY (8) OTHER (Describe Below) ❑ Eligible For Rehire ❑ Ineligible For Rehire ❑ VOLUNTEER (9) 1 Provide Details of Separation Below COMMENTS: Increase per wage survey -payment effective 1/1/17; deferred until February payroll. SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE ASSESSMENT COORDINATOR I OCCUPATION CODE 2487 UNION CODE 40 PAY GRADE 287 STEP / POSITION 5 FLSA STATUS ❑' Non -Exempt ❑ Exempt ❑ Not Covered Q Non -Exempt ❑ Exempt ❑ Not Covered DRS STATUS ❑ Ineligible ❑� PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible ❑� PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 8/6/2012 ADJ HIRE DATE 8/6/2012 POSITION DATE 9/1/2013 LAST RAISE DATE 1/1/2016 t ,1 n BASE WAGE $3,730.00 $4,320.00 LONGEVITY $ 0.00 $ FTE ❑� 100% ❑ 80% [:175% ❑ 60% ❑ 50% ❑� 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $3,730.00 $4,320.00 PAYMENT METHOD ❑ HOURLY ❑� MONTHLY ❑ HOURLY Q MONTHLY DEPARTMENT PUBLIC HEALTH BUDGET NUMBER A. 116 000000006118151001 %: 100.00 B. %: A. %: B. %: WORKWEEK ❑' Standard ❑ ALT/1't Friday off: ❑ 207(k) ❑' Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $ 0.00 $ 0.00 STIPEND (Detail in Comments Section) $ 0.00 $ 0.00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES (MUST BE SIGNER BLUE INK) DE T OFFICIAL DATE BUDGET/P YROLL DATE H MAN RESOURCE DATE I COMM E DATE M T I R ii TE COM l5ArE = 1 t C;? -f f RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update Eval Date Eval Rating (IE—ID—S—AA—S) Initial C� KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) Updated: 04/08/11 FOR HR USE: NT Update Eva[ Date I Eval Rating (IE—ID—S—AA—S) Initial SECTION 1: EMPLOYEE DATA LAST NAME Duncan FIRST NAME Holly EMPLOYEE # E0101 EFFECTIVE DATE 1/1/2017 SECTION 2: TYPE OF ACT_ ION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ❑r FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE ❑ MERIT/ STEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ❑ TERMINATION (Provide Separation Info) Q OTHER (Describe Below) ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ RETIRED (R) ❑ CONDUCT (C) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ OTHER (0) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire 11 Provide Details of Separation Below COMMENTS: Increase per wage survey -payment effective 1/1/17; deferred until February payroll. SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE ENVIRONMENTAL HEALTH SPEC 2 OCCUPATION CODE 2472 UNION CODE 40 PAY GRADE 272 STEP / POSITION 5 FLSA STATUS ❑' Non -Exempt ❑ Exempt ❑ Not Covered ❑' Non -Exempt ❑ Exempt [:]Not Covered DRS STATUS ❑ Ineligible ❑� PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible ❑� PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 4/18/1988 ADJ HIRE DATE 4/18/1988 POSITION DATE 5/1/1990 LAST RAISE DATE 1/1/2016 1 1 BASE WAGE $4,720.00 5,192.00 LONGEVITY $ 0.00 $ FTE ❑� 100% [180% ❑ 75% ❑ 60% ❑ 50% E 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $ 4,720.00 $ 5,192.00 PAYMENT METHOD ❑ HOURLY ❑� MONTHLY ❑ HOURLY ❑� MONTHLY DEPARTMENT PUBLIC HEALTH BUDGET NUMBER A. 116 000000000061551001 %: 100.00 A. %: B. %: B. W. WORKWEEK E Standard ❑ ALT/1g Friday off: ❑ 207(k) ElStandard ❑ ALT/1't Friday off: C1207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $ 0.00 $ 0.00 STIPEND (Detail in Comments Section) $ 0.00 $ 0.00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES (MUST BE SIGNED E INK) ENf+I W-ELEC-TEDOF CIAL DATE BUDGET/PAYR LL D#TE H MAN RESOURCE DATE COivIMI 0 #1 COM DATE RETURN FORM TO HUMAN RESOURNORMISTR12BUTIOP Updated: 04/08/11 FOR HR USE: NT Update Eva[ Date I Eval Rating (IE—ID—S—AA—S) Initial KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) Updated: 04/08/11 FOR HR USE: NT Update Eval Date EvalRating(IE— ID — S — AA — S) Initial SECTION 1: EMPLOYEE DATA LAST NAME Turnbull FIRST NAME EMPLOYEE # Justin T2689 EFFECTIVE DATE 01/01/2017 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ❑ FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT(7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE 0'h1Ei rfSrE ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ❑. RMINATION (Provide Separation Info) OTHER (Describe Below) ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ RETIRED (R) ❑ CONDUCT (C) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ OTHER (0) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Increase per wage survey - payment effective 1/1/17; deferred until February payroll. SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE COUNTY SURVEYOR OCCUPATION CODE 2378 UNION CODE 30 PAY GRADE 278 STEP / POSITION 5 FLSA STATUS ❑ Non -Exempt ❑' Exempt ❑ Not Covered ❑ Non -Exempt ❑' Exempt ❑ Not Covered DRS STATUS ❑ Ineligible ❑ PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible ❑ PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 5/2/2016 ADJ HIRE DATE 5/2/2016 POSITION DATE 5/2/2016 LAST RAISE DATE _- N38.00 BASE WAGE $6,250.00 $ LONGEVITY $ 0.00 $ FTE ED 100% ❑ 80% [:175% ❑ 60% ❑ 50% 100% [:180% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $ 6,250.00 $ 6,438.00 PAYMENT METHOD ❑ HOURLY ❑� MONTHLY ❑ HOURLY ❑' MONTHLY DEPARTMENT PUBLIC WORKS BUDGET NUMBER A. 000 RA3376 %: 100.00 a. %: A. %: B. %: WORKWEEK ❑' Standard ❑ ALT/1'` Friday off: ❑ 207(k) ❑' Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0", ALLOWANCE (Detail in Comments Section) $ 0.00 $ 0.00 STIPEND (Detail in Comments Section) $ 0.00 $ 0.00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES (MUST BE SIGNED IN BLUE INK) O P TMENT BEAD j EJECTED OFFICIAL DATE BUDGETJPAY i7 ATE H A RE URCE DATE COMMI # ATE CO OAT£ COMM \ I]AT RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update Eval Date EvalRating(IE— ID — S — AA — S) Initial KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) Updated: 04/08/11 FOR HR USE: NT Update Eval Date EvalRating(IE— ID — S —AA — S) Initial SECTION 1: EMPLOYEE DATA LAST NAME Van De Venter FIRST NAME Jim EMPLOYEE # V0048 EFFECTIVE DATE 01/01/2017 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION Q FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) NEW HIRE ❑ RE -HIRE ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ❑ TERMINATION (Provide Separation Info) WTHER (Describe Below) 1 ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) RETIRED (R) ❑ CONDUCT (C) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ OTHER (0) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Increase per wage survey -payment effective 1/1/17; deferred until February payroll. Cell phone allowance to continue. SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE MAINTENANCE MANAGER OCCUPATION CODE 1316 UNION CODE 30 PAY GRADE 116 STEP / POSITION 5 FLSA STATUS ❑ Non -Exempt [j] Exempt ❑ Not Covered ❑ Non -Exempt S Exempt ❑ Not Covered DRS STATUS ❑ Ineligible 0 PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible Q PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 3/2/1981 ADJ HIRE DATE 3/2/1981 POSITION DATE 8/1/2006 LAST RAISE DATE 1/1/2016 t BASE WAGE $ 5,501.00 $15,'866.00 LONGEVITY $ 0.00 $ FTE Q l00% ❑ 80% ❑ 75% ❑ 60% [:150% ❑O 100% ❑ 80% [:175% ❑60% [150% FTE WAGE $ 5,501.00 $ 5,866.00 PAYMENT METHOD ❑ HOURLY ❑ MONTHLY ❑ HOURLY Q MONTHLY DEPARTMENT PUBLIC WORKS BUDGET NUMBER A. 000 RA3376 %: 100.00 B. %.- A. %: B. %: WORKWEEK I] Standard ❑ ALT/1" Friday off: ❑ 207(k) I EE Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to '0". ALLOWANCE (Detail in Comments Section) $ 25.00 $ 25.00 STIPEND (Detail in Comments Section) $ 0.00 $ 0,00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES (MUST BE SIGNEDJIN BLUE INK) APARTMENT HEADS ELECTED 1)FFFGR i DATE ^ [fs 0-� ! BUDGET/ YRO ❑ TE a`� �/ ! H M N R SOURCE DATE COMMI qDA I ;/ CCI TIK� DATE E I COMNVnJI N AT�E/ RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update Eval Date EvalRating(IE— ID — S —AA — S) Initial C4 KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) Updated: 04/08/11 FOR HR USE: NT Update Eva IDate EvalRating(IE—ID—S—AA—S) Initial SECTION 1: EMPLOYEE DATA LAST NAME Reed FIRST NAME Chuck EMPLOYEE # R0108 EFFECTIVE DATE 01/01/2017 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION I] FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7)RMINATION ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE �S7.fiP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) (Provide Separation Info) UOTHER (Describe Below) ❑ DISCHARGE (D) ❑ RESIGNATION (Q) ❑ RETIRED (R) ❑ LAID OFF (L) ❑ FAIL PROBATION (P) ❑ OTHER (0) ❑ PERFORMANCE (P) ❑ ATTENDANCE (A) ❑ CONDUCT (C) ❑ OTHER EMPLOYMENT (E) ❑ PERSONAL (L) ❑ OTHER (0) ❑ EliCible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Increase per wage survey - payment effective 1/1/17; deferred until February payroll. SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE ROAD FOREMAN OCCUPATION CODE 1402 UNION CODE 40 PAY GRADE 102 STEP / POSITION 6 FLSA STATUS Non -Exempt ❑ Exempt ❑ Not Covered ❑' Non -Exempt ❑ Exempt ❑ Not Covered DRS STATUS ❑ Ineligible [j] PERS ❑ LEOFF ❑ PSERS ❑ Other [:1 Ineligible E] PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 10/3/1988 ADJ HIRE DATE 10/3/1988 POSITION DATE 6/11/2007 LAST RAISE DATE 1/1/2016 1 1 j BASE WAGE $4,867.00 (_ } -0 -9 IAV� $ 5,354.77 p ,M1� LONGEVITY $ 0.00 $ FTE [j] 100% ❑ ao% ❑ 7s% ❑ 60% ❑ so% (] l00% ❑ so% El7s% ❑ 60% ❑ so% FTE WAGE $ 4,867.00 \AR- $ 5,354.77 %b16. kAa_ PAYMENT METHOD ❑' HOURLY ❑ MONTHLY HOURLY ❑ MONTHLY DEPARTMENT PUBLIC WORKS BUDGET NUMBER A, 000 RA3376 %: 100.00 B. %: A. %: B. W WORKWEEK El Standard ❑ ALT/I" Friday off: ❑ 207(k) 0 Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to '0". ALLOWANCE (Detail in Comments Section) $ 0.00 $ 0.00 STIPEND (Detail in Comments Section) $ 0.00 $ 0.00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES (MUST BE SIGNED IN BLUE INK) ARTMENTHEAl3 ELECTED OF EIC L �7l ��fii111► 1 DATE U� G ��� �� BUDGETfPAY J DATE U N SOURCE DATE COMMISSi D 7 U CO R DATE CO MMI E CMTS AV RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update Eva IDate EvalRating(IE—ID—S—AA—S) Initial KITfITAS COUNTY PERSONNEL ACTION FORM (PAF) LAST NAME Leader _ SECTION 1: EMPLOYEE DATA FIRST NAME EMPLOYEE # EFFECTIVE DATE Candie L1668 01/01/2017 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ✓❑ FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE S-MEfttT-7-5TP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ❑ TERMINATION (Provide Separation Info) M-61,1ER (Describe Below) ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ RETIRED (R) ❑ CONDUCT (C) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ OTHER (0) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Increase per wage survey - payment effective 1/1/17; deferred until February payroll. SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE ADMINISTRATIVE ASSISTANT -PW OCCUPATION CODE 3360 UNION CODE 30 PAY GRADE 360 STEP / POSITION 5 FLSA STATUS ❑ Non -Exempt 0 Exempt ❑ Not Covered ❑ Non -Exempt 0 Exempt ❑ Not Covered DRS STATUS ❑ Ineligible Q PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible 0 PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 11/8/2004 ADJ HIRE DATE 11/8/2004 POSITION DATE 9/5/2013 LAST RAISE DATE 1/1/2016 BASE WAGE $ 3,155.00 $ 3,5!37.00 LONGEVITY $ 0.00 $ FTE ❑' 100% ❑ 80% [:175% ❑ 60% [:150% Q 100% ❑ 80% ❑ 75% ❑ 60% ❑ SO% FTE WAGE $ 3,155.00 $ 3,507.00 PAYMENT METHOD ❑ HOURLY [j] MONTHLY ❑ HOURLY [j] MONTHLY DEPARTMENT PUBLIC WORKS BUDGET NUMBER A. 000 RA3376 is 100.00 B. %: A. %: B. %: WORKWEEK El Standard ❑ ALT/1" Friday off: ❑ 207(k) El Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $ 0.00 $ 0,00 STIPEND (Detail in Comments Section) $ 0.00 $ 0,00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES (MUST BE SIGNED IN BLUE INK VP RTMV14THEAD/>£CTEDOFFICIAL DATE BUDGET/PAYR 4ADA' M RE OURCF DATE 1 COMMISSiO DATE C N' 92 DATE 2 C-11 - . COMMI 3 DATE - o; - 3 RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update Eval Date EvalRating(IE— ID — S — AA — S) Initial C41 KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) Updated: 04/08/11 FOR HR USE: NT Update ___ Eval Date — Eval Rating (IE -ID -S -AA -S) Initial SECTION 1: EMPLOYEE DATA LAST NAME Whitford FIRST NAME Lou EMPLOYEE # W2282 EFFECTIVE DATE 01/01/2017 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION FREASON FOR SEPARATION ❑✓ FULL-TIME (1) ❑ NEW HIRE ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ PART-TIME (2) ❑ RE -HIRE ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ LIMITED PART-TIME (3) ❑ MERIT/ STEP ❑ RETIRED (R) ❑ CONDUCT (C) ❑ TEMPORARY (4) ❑ POSITION CHANGE (Describe Below) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ CASUAL (5) ❑ BUDGET CHANGE (Describe Below) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ SEASONAL (6) ❑ LEAVE (List Type Below) ❑ OTHER (0) ❑ OTHER (0) ❑ PROJECT (7) ❑ TERMINATION (Provide Separation Info) ❑ WORK STUDY (8) ❑✓ OTHER (Describe Below) ❑ Eligible For Rehire ❑ Ineligible For Rehire ❑ VOLUNTEER (9) Provide Details of Separation Below COMMENTS: Increase per wage survey - payment effective 1/1/17; deferred until February payroll. SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE PLANS EXAMINER OCCUPATION CODE 2443 UNION CODE 40 PAY GRADE 243 STEP / POSITION 6 FLSA STATUS Non -Exempt [:]Exempt ❑Not Covered Q Non -Exempt ❑ Exempt ❑ Not Covered DRS STATUS ❑ Ineligible ❑' PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible Q PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 3/28/2011 ADJ HIRE DATE 3/28/2011 POSITION DATE 4/18/2011 LAST RAISE DATE 1/11/2016 k �• BASE WAGE $3,709.00 $4,647.00 LONGEVITY $ 0.00 $ FTE ❑ 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% Q 100% ❑ 80% ❑ 75% ❑ 60% E-150% FTE WAGE $3,709.00 $4,647.00 PAYMENT METHOD ❑ HOURLY [H] MONTHLY ❑ HOURLY Q MONTHLY DEPARTMENT COMMUNITY DEVELOPMENT SERVICES BUDGET NUMBER A. 402 000001042020151001 %: 100.00 B. %: A. Bio: B. %: WORKWEEK ❑� Standard ❑ ALT/1" Friday off: _ ❑ 207(k) ❑� Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0", ALLOWANCE (Detail in Comments Section) $ 0.00 $ 0.00 STIPEND (Detail in Comments Section) $ 0.00 $ 0.00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES (MUST BE SIGNED IN BLUE INK) D EN7 /ELECTED OFFICIAL DAT BUDGET/PAY Oil. ATE I HUMAN RESOURCE V"__/ DATE COMMIS t {] 7E COMNIE ER ` ATE d -e} I FOR DISTRIBUTION C +12 DATE i t RETURN FORM TO HUMAN RESOURCES Updated: 04/08/11 FOR HR USE: NT Update ___ Eval Date — Eval Rating (IE -ID -S -AA -S) Initial MA KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) LAST NAME Watson SECTION 1: EMPLOYEE DATA FIRST NAME EMPLOYEE # EFFECTIVE DATE Jeff W2082 01/01/2017 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION I REASON FOR SEPARATION ❑✓ FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8)✓❑ ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE ❑ MERIT / STEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ❑ TERMINATION (Provide Separation Info) OTHER (Describe Below) ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ RETIRED (R) ❑ CONDUCT (C) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ OTHER (0) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Increase per wage survey - payment effective 1/1/17; deferred until February payroll. SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE PLANNER/GIS SPECIALIST OCCUPATION CODE 2409 UNION CODE 40 PAY GRADE 209 STEP / POSITION 5 FLSA STATUS Non -Exempt ❑ Exempt ❑ Not Covered Q Non -Exempt ❑ Exempt ❑ Not Covered DRS STATUS ❑ Ineligible ❑' PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible ❑' PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 6/12/2008 ADJ HIRE DATE 6/12/2008 POSITION DATE 1/1/2016 LAST RAISE DATE 1/1/2016 Gl BASE WAGE $4,810.00 $5,651.00 LONGEVITY $0.00 $ FTE ❑� 100% ❑ 80% [:175% ❑ 60% ❑ 50% E] 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $4,810.00 $5,051.00 PAYMENT METHOD ❑ HOURLY ❑' MONTHLY ❑ HOURLY ❑ MONTHLY DEPARTMENT COMMUNITY DEVELOPMENT SERVICES BUDGET NUMBER A. 402 000000204211051001 %: 100.00 B. 9b: A. %: B. %: WORKWEEK 0 Standard ❑ ALT/1" Friday off: __ ❑ 207(k) I] Standard ❑ ALT/1" Friday off: __ ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $ 0.00 $ 0.00 STIPEND (Detail in Comments Section) $ 0.00 $ 0.00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES (MUST BE SIC INED IN BLUE INK) DENT H ELECTED OFFICIAL DA BUDGET PAYRO WE 711 HU AN R flU £ E ComISSSlk1 DATE r C 1 E Z DATE COM ATE RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update__ EvalDate _ Eval Rating (IE—ID—S—AA—S) Initial KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) LAST NAME Pilkington SECTION 1: EMPLOYEE DATA FIRST NAME EMPLOYEE # EFFECTIVE DATE Dusty P2700 01/01/2017 SECTION 2: TYPE OF ACTION TYPE OF SEPARATION 1 ❑ DISCHARGE (D) ❑ RESIGNATION (Q) ❑ RETIRED (R) ❑ LAID OFF (L) ❑ FAIL PROBATION (P) ❑ OTHER (0) EMPLOYEE TYPE EMPLOYEE ACTION REASON FOR SEPARATION ❑✓ FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE ❑ MERIT/ STEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ❑ TERMINATION (Provide Separation Info) ❑✓ OTHER (Describe Below) ❑ PERFORMANCE (P) ❑ ATTENDANCE (A) ❑ CONDUCT (C) ❑ OTHER EMPLOYMENT (E) ❑ PERSONAL (L) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Increase per wage survey -payment effective 1/1/17; deferred until February payroll. SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE PLANNER OCCUPATION CODE 2458 UNION CODE 40 PAY GRADE 258 STEP /POSITION 5 FLSA STATUS Q Non -Exempt ❑Exempt ❑Not Covered Q Non -Exempt ❑ Exempt ❑ Nat Covered DRS STATUS ❑ Ineligible ❑ PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible ❑ PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 5/23/2016 AD1 HIRE DATE 6/10/2016 POSITION DATE 5/23/2016 LAST RAISE DATE BASE WAGE $3,428.00 $4, 40.00 LONGEVITY $ 0.00 $ FTE 0 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% Q 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $3,428.00 $4,340.00 PAYMENT METHOD ❑ HOURLY Q MONTHLY ❑ HOURLY [H] MONTHLY DEPARTMENT COMMUNITY DEVELOPMENT SERVICES BUDGET NUMBER A. 402 000002042120151001 %: 100.00 B. %: A. %: B. %: WORKWEEK [KI Standard ❑ ALT/1" Friday off: __ ❑ 207(k) 0 Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to '0", ALLOWANCE (Detail in Comments Section) $ 0.00 $ 0.0Q STIPEND (Detail in Comments Section) $ 0.00 $ 0.00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES (MUST BE SI IN BLUE INK) KIFTMENT H / ELECTED OFFICIAL )AT( kV4 S/ � BUDGET/ AYRC#LC D.�AT HUMAN RESOURCE / f DA , COMMIS si ( DAT 1 C I DATE 2, I COM N 0 TE � --- �- RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update EvalDate _ EvalRating(IE— ID — S — AA — S) Initial j KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) Updated: 04/08/11 FOR HR USE: NT Update___ EvalDate ___ Eval Rating (IE—ID—S—AA—S) Initial I SECTION 1: EMPLOYEE DATA LAST NAME Mifflin FIRST NAME EMPLOYEE # EFFECTIVE DATE Steph M1615 01/01/2017 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ✓❑ FULL-TIME (1) ❑ NEW HIRE ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ PART-TIME (2) ❑ RE -HIRE ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ LIMITED PART-TIME (3) ❑ MERIT / STEP ❑ RETIRED (R) ❑ CONDUCT (C) ❑ TEMPORARY (4) ❑ POSITION CHANGE (Describe Below) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ CASUAL (5) ❑ BUDGET CHANGE (Describe Below) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ SEASONAL (6) ❑ LEAVE (List Type Below) ❑ OTHER (0) ❑ OTHER (0) ❑ PROJECT (7) ❑ TERMINATION (Provide Separation Info) ❑ WORK STUDY (8) ❑✓ OTHER (Describe Below) ❑ Eligible For Rehire ❑ Ineligible For Rehire ❑ VOLUNTEER (9) Provide Details of Separation Below COMMENTS: Increase per wage survey - payment effective 1/1/17; deferred until February payroll. JOB TITLE OCCUPATION CODE SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data SENIOR PERMIT TECHNICIAN 2399 UNION CODE 30 PAY GRADE 299 STEP / POSITION 5 FLSA STATUS ❑ Non -Exempt E Exempt ❑ Not Covered ❑ Non -Exempt ❑� Exempt ❑ Not Covered DRS STATUS ❑ Ineligible ❑� PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible ❑� PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 6/15/2009 ADJ HIRE DATE 3/14/2011 POSITION DATE 2/17/2014 LAST RAISE DATE 1/l/2016 BASE WAGE $3,887.00 $4,571.00 LONGEVITY $ 0.00 $ FTE Q 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50%❑ 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $3,887.00 $4,571.00 PAYMENT METHOD ❑ HOURLY ❑� MONTHLY []HOURLY ❑� MONTHLY DEPARTMENT COMMUNITY DEVELOPMENT SERVICES BUDGET NUMBER A. 402 000000104201051001 %: 100.00 B. %: A. %: B. %: WORKWEEK 0 Standard ❑ ALT/1" Friday off: ❑ 207(k) 0 Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0", ALLOWANCE (Detail in Comments Section) $ 0.00 $ 0.00 STIPEND (Detail in Comments Section) $ 0.00 $ 0.00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES (MUST BE SIGNED IN BLUE INK) TMENT D 1 ELECTED OFFICIAL DA OL1 BUDGET/ ATE S �/3 /r IiMAN RESOURCE Lr TE [2 C7 COMMIS # + DAT NER DATE 2` COMMISSION D E - r RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update___ EvalDate ___ Eval Rating (IE—ID—S—AA—S) Initial I �� KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) Updated: 04/08/11 FOR HR USE: NT Update ___ Eval Date ___ Eval Rating (IE - ID -S -AA- S) Initial SECTION 1: EMPLOYEE DATA _ LAST NAME lammarino FIRST NAME EMPLOYEE # EFFECTIVE DATE Lisa 11198 01/01/2017 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ✓❑ FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) [-ICASUAL (5) C]SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE ❑ MERIT/ STEP ElPOSITION CHANGE (Describe Below) E]BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ❑ TERMINATION (Provide Separation Info) ❑✓ OTHER (Describe Below) ❑ DISCHARGE (D) ❑ RESIGNATION (Q) ❑ RETIRED (R) ❑ LAID OFF (L) ❑ FAIL PROBATION (P) ElOTHER (0) ❑ PERFORMANCE (P) ❑ ATTENDANCE (A) ❑ CONDUCT (C) [:1OTHER EMPLOYMENT (E) [:1PERSONAL (L) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Increase per wage survey - payment effective 1/1/17; deferred until February payroll. SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE INVESTIGATION/ENFORCEMENT OFFI OCCUPATION CODE 2438 UNION CODE 40 PAY GRADE 238 STEP / POSITION 6 FLSA STATUS 0 Non -Exempt ❑ Exempt ❑ Not Covered Non -Exempt [:]Exempt ❑ Not Covered DRS STATUS ❑ Ineligible'❑ PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible ❑� PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 9/1/1998 ADJ HIRE DATE 10/1/1998 POSITION DATE 9/7/2004 LAST RAISE DATE 1/1/2016 t BASE WAGE $4,200.00 4,981.00 LONGEVITY $ 0.00 $ FTE E] 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% [j] 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $4,200.00 $4,981.00 PAYMENT METHOD ❑ HOURLY '❑ MONTHLY ❑ HOURLY ❑� MONTHLY DEPARTMENT COMMUNITY DEVELOPMENT SERVICES BUDGET NUMBER A. 402 000000304221051001 %: 100.00 B. %: A. %: B. %: WORKWEEK [D Standard ❑ ALT/1" Friday off: ❑ 207(k) [j] Standard ❑ ALT/I" Friday off: __ ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0", ALLOWANCE (Detail in Comments Section) $ 0,00 $ 0.00 STIPEND (Detail in Comments Section) $ 0,00 $ 0.00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES (MUST BE SIGNED IN BLUE INK) D / ELECTED OFFICIAL 7 9Aa /I ,DA7 BUDGET/P Vii OAT MAN RESOURCF DATE cOMM155I i D TF C ATE a t Com ~£ A . l3-I� RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update ___ Eval Date ___ Eval Rating (IE - ID -S -AA- S) Initial cl KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) SECTION 1: EMPLOYEE DATA LAST NAME Haberman FIRST NAME EMPLOYEE # EFFECTIVE DATE Jeremy H2573 01/01/2017 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ❑✓ FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE ❑ MERIT/ STEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ❑ TERMINATION (Provide Separation Info) OTHER (Describe Below) ❑ DISCHARGE (D) ❑ RESIGNATION (Q) ❑ RETIRED (R) ❑ LAID OFF (L) ❑ FAIL PROBATION (P) ❑ OTHER (0) ❑ PERFORMANCE (P) ❑ ATTENDANCE (A) ❑ CONDUCT (C) ❑ OTHER EMPLOYMENT (E) ❑ PERSONAL (L) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Increase per wage survey - payment effective 1/1/17; deferred until February payroll. SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE BUILDING INSPECTOR OCCUPATION CODE 2442 UNION CODE 40 PAY GRADE 242 STEP / POSITION 7 FLSA STATUS 0 Non -Exempt ❑ Exempt ❑ Not Covered Non -Exempt [:]Exempt ❑ Not Covered DRS STATUS ❑ Ineligible [j] PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible El PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 1/2/2015 ADJ HIRE DATE 1/2/2015 POSITION DATE 1/2/2015 LAST RAISE DATE 1/1/2016 BASE WAGE $3,390.00 $3,821.00 LONGEVITY $ 0.00 $ FTE [D 100% ❑ 80% ❑ 75% ❑ 60% [:150% ❑' 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $ 3,390.00 $ 3,821.00 PAYMENT METHOD ❑ HOURLY ❑� MONTHLY ❑ HOURLY[j] MONTHLY DEPARTMENT COMMUNITY DEVELOPMENT SERVICES BUDGET NUMBER A. 402 000001042020251001 %: 100.00 B. %: A. N.: B. %: WORKWEEK El Standard ❑ ALT/1" Friday off: __ ❑ 207(k) [D Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $ 0,00 $ 0.00 STIPEND (Detail in Comments Section) $ 0.00 $ 0.00 OTHER (Detail in Comments Section) $ 0,00 $ 0.00 SECTION 4: SIGNATURES (MUST BE SIGNED IN BLUE INK) 7 97MENT /MELEDOFFICIAL D TE BUDGETJPA7ROI RATE TE HU AN RESOURCE TE COMMM DTE COMM,IDATt r DATE RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update___ Eval Date _ EvalRating(IE— ID — S — AA — S) Initial Oft KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) Updated: 04/08/11 FOR HR USE: NT Update Eval Date EvalRating(IE—ID—S—AA—S) Initial SECTION 1: EMPLOYEE DATA LAST NAME Green FIRST NAME EMPLOYEE # EFFECTIVE DATE Amber A1744 01/01/2017 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ❑✓ FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE ❑ MERIT/ STEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ❑ TERMINATION (Provide Separation Info) ❑✓ OTHER (Describe Below) ❑ DISCHARGE (D) ❑ RESIGNATION (Q) ❑ RETIRED (R) ❑ LAID OFF (L) ❑ FAIL PROBATION (P) ❑ OTHER (0) ❑ PERFORMANCE (P) ❑ ATTENDANCE (A) ❑ CONDUCT (C) ❑ OTHER EMPLOYMENT (E) ❑ PERSONAL (L) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Increase per wage survey - payment effective 1/1/17; deferred until February payroll: SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE PLANS EXAMINER OCCUPATION CODE 2443 UNION CODE 40 PAY GRADE 243 STEP/ POSITION 5 FLSA STATUS [j] Non -Exempt ❑ Exempt ❑ Not Covered Q Non -Exempt ❑ Exempt ❑ Not Covered DRS STATUS ❑ Ineligible El PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible El PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 7/6/2005 ADJ HIRE DATE 7/6/2005 POSITION DATE 11/3/2014 LAST RAISE DATE 1/1/2016 1 BASE WAGE $3,795.00 $4,1647.00 LONGEVITY $ 0.00 $ FTE [j] 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% Q 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $3,795.00 $4,647.00 PAYMENT METHOD ❑ HOURLY Q MONTHLY ❑ HOURLY E] MONTHLY DEPARTMENT COMMUNITY DEVELOPMENT SERVICES BUDGET NUMBER A. 402 000001042020251001 %: 100.00 B. %: A. %: B. %: WORKWEEK � Standard ❑ ALT/I" Friday off: ___ ❑ 207(k) Q Standard ❑ ALT/0 Friday off: __ ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $ 0.00 $ 0.00 STIPEND (Detail in Comments Section) $ 0.00 $ 0.00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES (MUST BE SIGNED IN BLUE INK) FNT H D j ELECTED OFFICIAL I DATFj 3r� BUDGET/ IiYROL DATE - 1t N RESOURCE r DA E COMM, DATE //// -,4q ORR EDATE COMAts5rc E UA IX ri rI} RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update Eval Date EvalRating(IE—ID—S—AA—S) Initial _l KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) Updated: 04/08/11 FOR HR USE: NT Update EvalDate ___ EvalRating(IE—ID—S—AA—S) Initial SECTION 1: EMPLOYEE DATA LAST NAME Flory FIRST NAME Mike EMPLOYEE # F1696 EFFECTIVE DATE 01/01/2017 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ✓❑ FULL-TIME (1) ❑ NEW HIRE ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ PART-TIME (2) ❑ RE -HIRE ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ LIMITED PART-TIME (3) ❑ MERIT/ STEP ❑ RETIRED (R) ❑ CONDUCT (C) ❑ TEMPORARY (4) ❑ POSITION CHANGE (Describe Below) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ CASUAL (5) ❑ BUDGET CHANGE (Describe Below) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ SEASONAL (6) ❑ LEAVE (List Type Below) ❑ OTHER (0) ❑ OTHER (0) ❑ PROJECT (7) ❑ TERMINATION (Provide Separation Info) ❑ WORK STUDY (8)✓❑ OTHER (Describe Below) ❑ Eligible For Rehire ❑ Ineligible For Rehire ❑ VOLUNTEER (9) Provide Details of Separation Below COMMENTS: Increase per wage survey in September 2016 - 3% increase payment effective 1/1/17; deferred until February payroll. SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE BUILDING OFFICIAL OCCUPATION CODE 2310 UNION CODE 30 PAY GRADE 210 STEP / POSITION 5 FLSA STATUS ❑ Non -Exempt Q Exempt ❑ Not Covered ❑ Non -Exempt [j] Exempt ❑ Not Covered DRS STATUS ❑ Ineligible El PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible El PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 2/22/2005 ADJ HIRE DATE 2/22/2005 POSITION DATE 8/23/2016 LAST RAISE DATE 1/1/2016 1 j BASE WAGE $ 5,039.00 $ 5,190.00 LONGEVITY $ 0.00 $ FTE ❑� 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% ❑' 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $ 5,039.00 $ 5,190.00 PAYMENT METHOD ❑ HOURLY Q MONTHLY ❑ HOURLY E] MONTHLY DEPARTMENT COMMUNITY DEVELOPMENT SERVICES BUDGET NUMBER A. 402 000001042020151001 %: 100.00 B. %: A. %: B. %: WORKWEEK Il Standard ❑ ALT/1" Friday off: _ ❑ 207(k) E Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $ 0.00 $ 0.00 STIPEND (Detail in Comments Section) $ 0.00 $ 0.00 OTHER (Detail in Comments Section) $ 0.00 $ 0,00 SECTION 4: SIGNATURES (MUST BE SIGNED IN BLUE INK) D TM ENT D / ELECTED OFFICIAL TE 121f/ BUDGET/PAY O[L—' A TE � � ! HUMAN RESOURCF DATE COMMIS H DATE th-7- CDAIE, 1 2 \ i COMM O " AT r-� --� RETURN FORM TO HUMAN RESOURC FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update EvalDate ___ EvalRating(IE—ID—S—AA—S) Initial C_` KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) i LAST NAME Benner EMPLOYEE TYPE SECTION 1: EMPLOYEE DATA _ FIRST NAMELOYEE # EFFECTIVE DATE Chelsea B2658 01/01/2017 r SECTION 2: TYPE OF ACTION EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ❑✓ FULL-TIME (1) ❑ NEW HIRE ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ PART-TIME (2) ❑ RE -HIRE ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ LIMITED PART-TIME (3) ❑ MERIT/ STEP ❑ RETIRED (R) ❑ CONDUCT (C) ❑ TEMPORARY (4) ❑ POSITION CHANGE (Describe Below) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ CASUAL (5) ❑ BUDGET CHANGE (Describe Below) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ SEASONAL (6) ❑ LEAVE (List Type Below) ❑ OTHER (0) ❑ OTHER (0) ❑ PROJECT (7) ❑ TERMINATION (Provide Separation Info) ❑ WORK STUDY (8)✓❑ OTHER (Describe Below) ❑ Eligible For Rehire ❑ Ineligible For Rehire ❑ VOLUNTEER (9) Provide Details of Separation Below COMMENTS: Increase per wage survey - payment effective 1/1/17; deferred until February payroll. SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE PERMIT TECHNICIAN OCCUPATION CODE 2441 UNION CODE 40 PAY GRADE 241 STEP / POSITION 6 FLSA STATUS E] Non -Exempt ❑ Exempt ❑ Not Covered 0 Non -Exempt ❑ Exempt ❑ Not Covered DRS STATUS ❑ Ineligible ❑ PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible ❑ PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 12/7/2015 ADJ HIRE DATE 12/7/2015 POSITION DATE 12/7/2015 LAST RAISE DATE 1/1/2016 BASE WAGE $ 3,256.00 $ 3,583.00 LONGEVITY $ 0.00 $ FTE ❑' 100/ ❑ 80% ❑ 75% ❑ 60% ❑ 50% [E 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $ 3,256.00 $ 3,583.00 PAYMENT METHOD ❑ HOURLY ❑' MONTHLY ❑ HOURLY ❑� MONTHLY DEPARTMENT COMMUNITY DEVELOPMENT SERVICES BUDGET NUMBER A. 402 000000104201051001 %: 100.00 B. %: A. %: B. %: WORKWEEK [j] Standard ❑ ALT/1" Friday off: ❑ 207(k) S Standard ❑ ALT/1" Friday off: __ ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to '0". ALLOWANCE (Detail in Comments Section) $ 0.00 $ 0.00 STIPEND (Detail in Comments Section) $ 0.00 $ 0.00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES (MUST BE SIG IN BLUE INK) TMENT O /ELECTED OFFICIAL AAT BUDGET/ AYROL DTE H AN RESOURCE DATE COMM I ER 0 TE =—qn DATE ` i CO SIO DATE l — ~! / 4�rr6�elC2 RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update ____ Eval Date — Eval Rating (IE—ID—S—AA—S) Initial �'i . KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) LAST NAME Bennett SECTION 1: EMPLOYEE DATA FIRST NAME EMPLOYEE # EFFECTIVE DATE Justin B2574 01/01/2017 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ✓❑ FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE ❑ MERIT/ STEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ❑ TERMINATION (Provide Separation Info) ❑✓ OTHER (Describe Below) ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ RETIRED (R) ❑ CONDUCT (C) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ OTHER (0) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Increase per wage survey - payment effective 1/1/17; deferred until February payroll. SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE BUILDING INSPECTOR OCCUPATION CODE 2442 UNION CODE 40 PAY GRADE 242 STEP / POSITION 6 FLSA STATUS ❑' Non -Exempt ❑ Exempt ❑ Not Covered Q Non -Exempt ❑ Exempt ❑ Not Covered DRS STATUS ❑ Ineligible Il PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible 0 PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 1/2/2015 ADJ HIRE DATE 1/2/2015 POSITION DATE 1/2/2015 LAST RAISE DATE 1/1/2016 BASE WAGE $3,390.00 $3, 21.00 LONGEVITY $ 0.00 $ FTE ❑� 100% ❑ 80% ❑ 75% ❑ 60% [:150% ❑ 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $ 3,390.00 $ 3,821.00 PAYMENT METHOD ❑ HOURLY '❑ MONTHLY ❑ HOURLY[j] MONTHLY DEPARTMENT COMMUNITY DEVELOPMENT SERVICES BUDGET NUMBER A. 402 000001042020251001 %: 100.00 B. %: A. %: B. %: WORKWEEK [j] Standard ❑ ALT/1" Friday off: ❑ 207(k) E] Standard ❑ ALT/1s` Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $ 0.00 $ 0.00 STIPEND (Detail in Comments Section) $ 0.00 $ 0.00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES (MUST BE SIGNED I $LUE INK) TMENT / EL TED OFFICIAL Z4 DATE BUDGET/PAYRO L DA HUMAN REOURCE (1131Y-7 DA ECOMM i p DATE C 6ATE COM I NER ATE RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update Eval Date Eval Rating (IE — ID — S —AA — S) Initial Q� () KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) _ LAST NAME Contratto SECTION 1: EMPLOYEE DATA FIRST NAME EMPLOYEE # EFFECTIVE DATE Jessica C2505 01/01/2017 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ❑� FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE ❑ MERIT/ STEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ❑ TERMINATION (Provide Separation Info) ❑✓ OTHER (Describe Below) ❑ DISCHARGE (D) ❑ RESIGNATION (Q) ❑ RETIRED (R) ❑ LAID OFF (L) ❑ FAIL PROBATION (P) ❑ OTHER (0) ❑ PERFORMANCE (P) ❑ ATTENDANCE (A) ❑ CONDUCT (C) ❑ OTHER EMPLOYMENT (E) ❑ PERSONAL (L) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Increase per wage survey - payment effective 1/1/17; deferred until February payroll. SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE BUILDING INSPECTOR OCCUPATION CODE UNION CODE 2442_ 40 PAY GRADE 242 STEP / POSITION 6 FLSA STATUS (j] Non -Exempt ❑ Exempt ❑ Not Covered [j] Non -Exempt ❑ Exempt ❑ Not Covered DRS STATUS ❑ Ineligible Q PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible ❑� PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 2/10/2014 ADJ HIRE DATE 2/10/2014 POSITION DATE 2/10/2014 LAST RAISE DATE 1/1/2016 j. BASE WAGE $ 3,458.00 $ 3,821.00 LONGEVITY $ 0.00 $ FTE Q 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% ❑ 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $ 3,458.00 $ 3,821.00 PAYMENT METHOD ❑ HOURLY ❑ MONTHLY ❑ HOURLY 0 MONTHLY DEPARTMENT COMMUNITY DEVELOPMENT SERVICES BUDGET NUMBER A. 402 000001042020251001 %: 100.00 s. %: A. %: I B. %: WORKWEEK E] Standard ❑ ALT/1" Friday off: ❑ 207(k) I Q Standard ❑ ALT/1" Friday off: ___ ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $ 0.00 $ 0.00 STIPEND (Detail in Comments Section) $ 0.00 $ 0.00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES (MUST BE SIGNED IN BLUE INK) �fiTMENrT D / ELECTED OFFICIAL 3 D7/7 BUDGET/Ir1CYRO DYE H AN RESO CE T DTE , -1 COMMI DAT 1 C 0 E (DATE COM %D 1'E ^/ RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE. NT Update __ EvalDate ___ EvalRating(IE— ID — S — AA — S) Initial KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) SECTION 1: EMPLOYEE DATA LAST NAME Cook FIRST NAME Mark EMPLOYEE # C2618 EFFECTIVE DATE 01/01/2017 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ✓❑ FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE � ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) [TERMINATION (Provide Separation Info) W7HER (Describe Below) ❑ DISCHARGE (D) ❑ RESIGNATION (Q) ❑ RETIRED (R) ❑ LAID OFF (L) ❑ FAIL PROBATION (P) ❑ OTHER (0) ❑ PERFORMANCE (P) ❑ ATTENDANCE (A) ❑ CONDUCT (C) ❑ OTHER EMPLOYMENT (E) ❑ PERSONAL (L) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Increase per wage survey - payment effective 1/1/17; deferred until February payroll. SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE PUBLIC WORKS DIRECTOR OCCUPATION CODE 1318 UNION CODE 30 PAY GRADE 118 STEP / POSITION 5 FLSA STATUS ❑ Non -Exempt 0 Exempt ❑ Not covered ❑ Non -Exempt ❑� Exempt ❑ Not Covered DRS STATUS ❑ Ineligible (] PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible [j] PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 5/4/2015 ADJ HIRE DATE 5/4/2015 POSITION DATE 5/4/2015 LAST RAISE DATE 1/1/2016 BASE WAGE $8,935.00 $9,829.00 LONGEVITY $ 0.00 $ FTE ❑� 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% ❑' 100% [:180% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $ 8,935.00 $ 9,829.00 PAYMENT METHOD ❑ HOURLY ❑' MONTHLY ❑ HOURLY ❑� MONTHLY DEPARTMENT PUBLIC WORKS BUDGET NUMBER WORKWEEK A. 000 RA3376 is 100.00 B. OW A. is B. %: 0 Standard ❑ ALT/1" Friday off: ❑ 207(k) E Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $ 0.00 $ 0.00 STIPEND (Detail in Comments Section) $ 0.00 $ 0.00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES (MUST BE SIGNED IN BLUE INK) P RTMENT HEAD/ EVCTEDCIFFICI DATE BUDGET/PAY OAT /��r uRce TM rE 2 T COMM DA ❑ ! ER DATE CO I ` ^ _ � �E -, RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update Eval Date Eval Rating (IE - ID - S -AA - S) Initial CAL ' KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) Updated: 04/08/11 FOR HR USE: NT Update EvalDate EvalRating(IE—ID—S—AA—S) Initial SECTION 1: EMPLOYEE DATA LAST NAME Berge FIRST NAME Ryan EMPLOYEE # B1254 EFFECTIVE DATE 01/01/2017 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION Q FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE TTEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ,TERMINATION (Provide Separation Info) THER (Describe Below) ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ RETIRED (R) ❑ CONDUCT (C) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ OTHER (0) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Increase per wage survey - payment effective 1/1/17; deferred until February payroll. Cell phone allowance to continue. SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE ROAD FOREMAN OCCUPATION CODE 1402 UNION CODE 40 PAY GRADE 102 STEP / POSITION 5 FLSA STATUS E] Non -Exempt [:]Exempt ❑ Not Covered 0 Non -Exempt ❑ Exempt ❑ Not Covered DRS STATUS ❑ Ineligible ❑� PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible ❑O PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 6/22/1999 ADJ HIRE DATE 6/22/1999 POSITION DATE 9/1/2006 LAST RAISE DATE 1/1/2016 1 BASE WAGE $ 4,867.00 �X! .QS 04- $ 5,354.27 LONGEVITY 1 $ 0.00 $ FTE ❑' 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% ❑p 100% ❑ 80% [175% ❑ 60% ❑ 50% FTE WAGE $4,867.00 'g,.p Y- $5,354.27 -j0, '{ WQj PAYMENT METHOD ❑' HOURLY ❑ MONTHLY ❑� HOURLY ❑ MONTHLY DEPARTMENT PUBLIC WORKS BUDGET NUMBER A. 000 RA3376 %: 100.00 B. M: A. %: B. %: WORKWEEK 2 Standard ❑ ALT/1" Friday off: ❑ 207(k) ❑� Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to '0:'. ALLOWANCE (Detail in Comments Section) $ 25.00 $ 25.00 71. STIPEND (Detail in Comments Section) $ 0.00 $ 0.00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES MUST BE SIGNED IN BLUE INK) TMENT HEAD / ELUTED OFFICIAL A DATE �l.cl IIV D��jO 1" BUDGET/P � A/ E 97 / 4 MA RES URGE DATE CO D CO i55 ATE C I ER 1{ O RETURN FORM TO HUMAN RESOURCES FOR DISTRIBOfthr Updated: 04/08/11 FOR HR USE: NT Update EvalDate EvalRating(IE—ID—S—AA—S) Initial C_J, `+ KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) LAST NAME Folk SECTION 1: EMPLOYEE DATA FIRST NAME EMPLOYEE # EFFECTIVE DATE Sara F2719 01/01/2017 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ❑� FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE , +�MMU44W ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ❑ TERMINATION (Provide Separation Info) THER (Describe Below) ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ RETIRED (R) ❑ CONDUCT (C) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ OTHER (0) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Increase per wage survey - payment effective 1/1/17; deferred until February payroll. SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE CONSTRUCTION MANAGER OCCUPATION CODE 2326 UNION CODE 30 PAY GRADE 226 STEP / POSITION 5 FLSA STATUS ❑ Non -Exempt 0 Exempt ❑ Not Covered ❑ Non -Exempt 0 Exempt ❑ Not Covered DRS STATUS ❑ Ineligible ❑ PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible ❑ PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 9/6/2016 ADJ HIRE DATE 9/6/2016 POSITION DATE 9/6/2016 LAST RAISE DATE BASE WAGE $6,833.00 $7,038.00 LONGEVITY $ 0.00 $ FTE ❑� 100% El ❑ 75% ❑ 60% ❑ 50% ❑� 100% El80% ❑ 75% ❑ 60% -150% FTE WAGE $ 6,833.00 $ 7,038.00 PAYMENT METHOD ❑ HOURLY ❑� MONTHLY ❑ HOURLY ❑� MONTHLY DEPARTMENT PUBLIC WORKS BUDGET NUMBER A. 000 RA3376 %: 100.00 B. %: A. %: B. %: WORKWEEK ❑' Standard ❑ ALT/1" Friday off: ❑ 207(k) El Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $ 0.00 $ 0.00 STIPEND (Detail in Comments Section) $ 0.00 $ 0.00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES (MUST BE SIGNED IN BLUE INK) RTMIENT HEAD. j ELE;TED 0rFICIAI. DATE ` BUDGET AYRO DATE M Rf5 URLE DATE COMM! R DAT -- Z — 'm i 12/ C 5510 E N2 DATE Z I 1 COM / TE ~/ RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update Eval Date Eval Rating (IE — ID — S — AA — S) Initial C� e`l KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) Updated: 04/08/11 FOR HR USE: NT Update Eva[Date Eval Rating (IE—ID—S—AA-5) Initial SECTION 1: EMPLOYEE DATA LAST NAME Kauzlarich FIRST NAME Tim EMPLOYEE # K1164 EFFECTIVE DATE 01/01/2017 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ❑� FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE W*B"rrsm ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ❑ TERMINATION (Provide Separation Info) ,(4VOIHER (Describe Below) ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ RETIRED (R) ❑ CONDUCT (C) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ OTHER (0) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Increase per wage survey - payment effective 1/1/17; deferred until February payroll. Cell phone allowance to continue. SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE TRAFFIC FOREMAN OCCUPATION CODE 4404 UNION CODE 40 PAY GRADE 404 STEP / POSITION 1 FLSA STATUS 0 Non -Exempt ❑ Exempt ❑ Not Covered Q Non -Exempt ❑ Exempt ❑ Not Covered DRS STATUS ❑ Ineligible ❑� PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible ❑� PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 3/2/1998 ADJ HIRE DATE 3/2/1998 POSITION DATE 1/1/2017 LAST RAISE DATE 1/1/2016 BASE WAGE $ 4,896.67 }q, . $5,026.67 0b Ai - LONGEVITY $ 0.00 $ FTE p l00% El8o% ❑ 75% ❑ 60% ❑ so% p l00% ❑ 8o% ❑ 75% ❑ 60% ❑ sor FTE WAGE $4,896.67 P4, $5,026.67 PAYMENT METHOD ❑� HOURLY ❑ MONTHLY ❑� HOURLY ❑ MONTHLY DEPARTMENT PUBLIC WORKS BUDGET NUMBER A. 000 RA3376 %: 100.00 B. %: A. %: B. %: WORKWEEK j 0 Standard ❑ ALT/1" Friday off: ❑ 207(k) ❑� Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will de cult to V".. ALLOWANCE (Detail in Comments Section) $ 25.00 $ 25.00 t% STIPEND (Detail in Comments Section) $ 0,00 $ 0.00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES MUST BE SIGNED IN BLUE INK) E A TMENT HEAD / CTED OFFICIAL DATE BUDGET/PAYROL DATE 1311 -7 H M RES L1RCE /) OTE COM R t p E C 14 .R #2) DATE COM /ATE / RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update Eva[Date Eval Rating (IE—ID—S—AA-5) Initial C--� KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) Updated: 04/08/11 FOR HR USE: NT Update Eval Date__ Eval Rating (IE — ID — S —AA—S) Initial SECTION 1: EMPLOYEE DATA LAST NAME Adams FIRST NAME Willie EMPLOYEE # A2038 EFFECTIVE DATE 01/01/2017 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ❑� FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE W44Eft"1 STIP' ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) a7ERMINATION (Provide Separation Info) POTHER (Describe Below) ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ RETIRED (R) ❑ CONDUCT (C) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ OTHER (0) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Increase per wage survey - payment effective 1/1/17; deferred until February payroll. SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE SHOP FOREMAN OCCUPATION CODE 1424 UNION CODE 40 PAY GRADE 124 STEP / POSITION 6 FLSA STATUS 0 Non -Exempt ❑ Exempt ❑ Not Covered Q Non -Exempt ❑ Exempt ❑ Not Covered DRS STATUS ❑ Ineligible Q PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible ❑� PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 3/3/2008 ADJ HIRE DATE 3/3/2008 POSITION DATE 3/3/2008 LAST RAISE DATE 1/1/2016 BASE WAGE $4,732.00 . U L $ k205.20 -�O.!)a { LONGEVITY $ 0.00 $ FTE ❑' 100% ❑ 80% ❑ 75% El60% ❑ SO% ❑ 100% [:180% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $4,732.00 ",_ 1l HSR- $ 5,205.20 :270 PAYMENT METHOD ❑' HOURLY ❑ MONTHLY El HOURLY ❑ MONTHLY DEPARTMENT PUBLIC WORKS BUDGET NUMBER A. 000 RA3376 %: 100.00 B. %: A. %: B. %: WORKWEEK [j] Standard ❑ ALT/1" Friday off: ❑ 207(k) Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to ','0". ALLOWANCE (Detail in Comments Section) $ 0.00 $ 0.00 STIPEND (Detail in Comments Section) $ 0.00 $ 0.00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES (MUST BE SIGNED IN BLUE INK) RTMENT HEAD / E CTED OFFICIAL DATE BUDGET/ P RQL AT FMA RES URGE DATECOMM, 1DOTE C 1 NER 2 DATE i l COM �— RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update Eval Date__ Eval Rating (IE — ID — S —AA—S) Initial LAST NAME Drain KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) SECTION 1: EMPLOYEE DAIA FIRST NAME EMPLOYEE # EFFECTIVE DATE Andrew D1576 COMMENTS: Increase per wage survey -payment effective 1/1/17; deferred until February payroll 1 X71 �t ;+i r3 yE.I�AlLtnet? _ hn OIWIIA.IkL. 1A SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION — REASON FOR SEPARATION Q FULL-TIME (1) ❑ NEW HIRE ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ PART-TIME (2) ❑ RE -HIRE ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ LIMITED PART-TIME (3) ' ❑ 4kRIT/STEP ❑ RETIRED (R) ❑ CONDUCT (C) ❑ TEMPORARY (4) ❑ POSITION CHANGE (Describe Below) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ CASUAL (5) ❑ BUDGET CHANGE (Describe Below) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ SEASONAL (6) ❑ LEAVE (List Type Below) ❑ OTHER (0) ❑ OTHER (0) ❑ PROJECT (7) 1 TERMINATION (Provide Separation Info) ❑ Ineligible ❑ PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ WORK STUDY (8) O'l HER (Describe Below) ❑ Eligible For Rehire ❑ Ineligible For Rehire ❑ VOLUNTEER (9) 6/26/2007 Provide Details ofSeparatian Below COMMENTS: Increase per wage survey -payment effective 1/1/17; deferred until February payroll 1 X71 �t ;+i r3 yE.I�AlLtnet? _ hn OIWIIA.IkL. 1A SECTION 3: POSITION DATA Enter existing data corn CAMAS Wage Data Report Enter new data JOB TITLE APPLICATION DEV MGR OCCUPATION CODE 2330 UNION CODE 30 PAY GRADE 230 STEP / POSITION 5 FLSA STATUS ❑ Non -Exempt 0 Exempt ❑ Not Covered ❑ Non -Exempt 0 Exempt ❑ Not Covered DRS STATUS ❑ Ineligible Q PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible ❑ PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 6/26/2007 ADJ HIRE DATE 6/26/2007 POSITION DATE 1/1/2016 LAST RAISE DATE 1/1/2016 Y BASE WAGE $5,208.00 $5, 28.00 LONGEVITY $ 0.00 $ FTE 2 100% ❑ 80% ❑ 75% [160% ❑ 50% ❑ 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $5,208.00 $5,728.00 PAYMENT METHOD ❑ HOURLY ❑� MONTHLY ❑ HOURLY 2 MONTHLY DEPARTMENT INFORMATION TECHNOLOGY BUDGET NUMBER A. 001 000000000001751001 %: 100.00 A. %: B. %: B. %: WORKWEEK EStandard ❑ ALT/1" Friday off: ❑ 207(k) E Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0", ALLOWANCE (Detail in Comments Section) $ 60.00 $ 60.00 STIPEND (Detail in Comments Section) $ 0.00 $ 0.00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES (MUST BE SIGNERA BLUE INK) DEPARTMENT- FFICTAL _ - DATE BUDGET/P YAOLL DATE _ rr'' HUMAN RESOURCE AT£ COMM DATE L~ � VDE, CO M1SJ DATE1 COM NE RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update EvalDate Eval Rating (IE—ID—S—AA—S) Initial L KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) SECTION 1: EMPLOYEE DATA ' LAST NAME Enterexisting data/ram CAMAS Wage Data Report FIRST NAME EMPLOYEE # EFFECTIVE DATE Davis OCCUPATION CODE Bill D2342 rt=Tl7 30 SECTION 2: TYPE OF ACTION PAY GRADE EMPLOYEE TYPE I EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ❑✓ FULL-TIME (1) ❑ NEW HIRE ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ PART-TIME (2) Q J&HIRE ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ELIMITED PART-TIME (3) OMERIT/STEP RETIRED (R) CONDUCT (C) ❑ TEMPORARY (4) E POSITION CHANGE (Describe Below) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ CASUAL (5) ❑ BUDGET CHANGE (Describe Below) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ SEASONAL (6) ❑ LEAVE (List Type Below) ❑ OTHER (0) ❑ OTHER (0) ❑ PROJECT (7) ❑ TERMINATION (Provide Separation Info) p 100% E 80% E 75% E 60% ❑ so% p 100% E 80°r -175% El 60% ❑ so% E] Eligible For Rehire ❑ Ineligible For Rehire ❑ WORK STUDY (8)OTHER (Describe Below) Provide Details of Separation Below ❑ VOLUNTEER (9) DEPARTMENT COMMENTS: Increase per wage surrey - payment effective 1/1/17; deferred until February payroll. BUDGET NUMBER A. 001 000000000001751001 %: 100.00 B. %: A. %: B. %: WORKWEEK E Standard ❑ ALT/1" Friday off: ❑ 207(k) SECTION 3: POSITION DATA To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount wru aefourt to --u , ALLOWANCE (Detail in Comments Section) $ 60.00 $ 60.00 STIPEND (Detail in Comments Section) $ 0.00 $ 0.00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES_(MUST BE SIGNED IN BLUE IN DEPARTMENT; .D :IVECTED.OFFICIAL DATE BUDGETJP�VM ZleDATE Fitt AN RE50Li nAiE� COMMI DTE r 14 � DATE CO DACE t RETURN FORM TO HiiMAN RESOD CES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update Eval Date EvalRating(IE— ID — S — AA — S) Initial Enterexisting data/ram CAMAS Wage Data Report Enter new data JOB TITLE SYSTEM ADMINISTRATOR OCCUPATION CODE 2344 UNION CODE 30 PAY GRADE 244 STEP / POSITION 5 FLSA STATUS ❑ Non -Exempt ❑' Exempt ❑ Not Covered ❑ Non -Exempt Q Exempt ❑ Not Covered DRS STATUS ❑ Ineligible ED PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible El PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 9/19/2012 ADJ HIRE DATE 9/19/2012 POSITION DATE 9/19/2012 LAST RAISE DATE 1/1/2016 ! 4 BASE WAGE $ 4,780.00 $ 5,139.00 LONGEVITY $ 0.00 $ FTE p 100% E 80% E 75% E 60% ❑ so% p 100% E 80°r -175% El 60% ❑ so% FTE WAGE $ 4,780.00 $ 5,139.00 PAYMENT METHOD ❑ HOURLY ❑� MONTHLY []HOURLY ❑� MONTHLY DEPARTMENT INFORMATION TECHNOLOGY BUDGET NUMBER A. 001 000000000001751001 %: 100.00 B. %: A. %: B. %: WORKWEEK E Standard ❑ ALT/1" Friday off: ❑ 207(k) E Standard E ALT/1" Friday off: _ ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount wru aefourt to --u , ALLOWANCE (Detail in Comments Section) $ 60.00 $ 60.00 STIPEND (Detail in Comments Section) $ 0.00 $ 0.00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES_(MUST BE SIGNED IN BLUE IN DEPARTMENT; .D :IVECTED.OFFICIAL DATE BUDGETJP�VM ZleDATE Fitt AN RE50Li nAiE� COMMI DTE r 14 � DATE CO DACE t RETURN FORM TO HiiMAN RESOD CES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update Eval Date EvalRating(IE— ID — S — AA — S) Initial KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) LAST NAME Eklund SECTION 1: EMPLOYEE DATA FIRST NAME EMPLOYEE # EFFECTIVE DATE Jason E1948 —1 / a 20111 i- - I - - � �� /i --Z 1 EMPLOYEE TYPE SECTION 2: TYPE OF ACTION EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ❑✓ FULL-TIME (1) ❑ NEW HIRE ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ PART-TIME (2) ❑ ftE-HIRE ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ LIMITED PART-TIME (3) �❑ 'q)fERIT / STEP ❑ RETIRED (R) ❑ CONDUCT (C) ❑ TEMPORARY (4) ❑ POSITION CHANGE (Describe Below) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ CASUAL (5) ❑ BUDGET CHANGE (Describe Below) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ SEASONAL (6) ❑ LEAVE (List Type Below) ❑ OTHER (0) ❑ OTHER (0) ❑ PROJECT (7) ❑ TERMINATION (Provide Separation Info) ❑ WORK STUDY (8) ,❑'(Y HER (Describe Below) 1 ❑ Eligible For Rehire ❑ Ineligible For Rehire ❑ VOLUNTEER (9) Provide Details of Separation Below COMMENTS: Increase per wage survey - payment effective 1/1/17; deferred until February payroll. WX, Y1U-L � Lev SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE GIS COORDINATOR OCCUPATION CODE 2313 UNION CODE 30 PAY GRADE 213 STEP / POSITION 5 FLSA STATUS ❑ Non -Exempt [j] Exempt ❑ Not Covered ❑ Non -Exempt 0 Exempt ❑ Not Covered DRS STATUS ❑ Ineligible El PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible 0 PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 2/27/2007 ADJ HIRE DATE 2/27/2007 POSITION DATE 2/27/2007 LAST RAISE DATE 1/1/2016 jq BASE WAGE $ 5,207.00 $ 5;513.00 LONGEVITY $ 0.00 $ FTE ❑� 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% ❑p 100% ❑ 80% [:175% ❑60% ❑ 50% FTE WAGE $ 5,207.00 $ 5,513.00 PAYMENT METHOD ❑ HOURLY 0 MONTHLY ❑ HOURLY ❑' MONTHLY DEPARTMENT INFORMATION TECHNOLOGY BUDGET NUMBER A. 001 000000000001751001 %; 100.00 B. %: A. %; B. %: WORKWEEK [D Standard ❑ ALT/1" Friday off: ❑ 207(k) ❑' Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0", ALLOWANCE (Detail in Comments Section) $ 60.00 $ 60.00 STIPEND (Detail in Comments Section) $ 0,00 $ 0.00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES (MUST BE SIGNED IN BLUE INK) DEPAR-A+JEiYI �' IiD OFFICIAL DATE BUDGETIPAYR CL RTE HUMAN RESOURCE DATE ' 1 , COMMIS Elf DATE 01 COM R g DATE COMMIS N O E RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update Eval Date EvalRating(IE— ID — S — AA — S) Initial FA KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) LAST NAME Fessler SECTION 1: EMPLOYEE DATA FIRST NAME EMPLOYEE # EFFECTIVE DATE Doug F2374 17 EMPLOYEE TYPE SECTION 2: TYPE OF ACTION EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ❑✓ FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE ❑4RIT/STEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) C1 TERMINATION (Provide Separation Info) Elf OTFiF R (Describe Below) ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ RETIRED (R) ❑ CONDUCT (C) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ OTHER (0) ❑ OTHER (0) 0 Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Increase per wage survey - payment effective 1/1/17; deferred until February payroll. r 1) r 4, SECTION 3: POSITION DATA Enter existing datafrom CAMAS Wage Data Report Enter new data JOB TITLE NETWORK ADMINISTRATOR OCCUPATION CODE 2334 UNION CODE 30 PAY GRADE 234 STEP / POSITION 1 FLSA STATUS ❑ Non -Exempt Q Exempt ❑ Not Covered ❑ Non -Exempt ❑Q Exempt ❑ Not Covered DRS STATUS ❑ Ineligible E PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible E PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 5/21/2012 ADJ HIRE DATE 5/21/2012 POSITION DATE 5/21/2012 LAST RAISE DATE 1/1/2016 BASE WAGE $ 5,222.00 $ 5,377.00 LONGEVITY $ 0.00 .$ FTE E 100% ❑ 80% ❑ 75% ❑ 60% [:150% E 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $ 5,222.00 $ 5,377.00 PAYMENT METHOD ❑ HOURLY ❑Q MONTHLY ❑ HOURLY E MONTHLY DEPARTMENT INFORMATION TECHNOLOGY BUDGET NUMBER A. 001 000000000001751001 %: 100.00 B. %: A. %: B. %: WORKWEEK E Standard ❑ ALT/1" Friday off: ❑ 207(k) I E Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $ 60.00 $ 60.00 STIPEND (Detail in Comments Section) $ 0,00 $ 0.00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES (MUST BE SIG BLUE INK) DEPA7 tJH ELECTEDOFFlC1AL OATS - SSC' BUDGET/ P ROL OA . I! HUMAN-RE90U$CE P DATE COMM 1 11 DATE 1 C ❑ 2 ; FATE LO • l �_43TE/ RETURN FORM TO HUMAN RESOURCES FOR DISTRI9UTTO Updated: 04/08/11 FOR HR USE: NT Update Eval Date Eval Rating (IE—ID—S—AA—S) Initial (J, KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) r SECTION 1: EMPLOYEE DATA LAST NAME Kinney FIRST NAME Zane EMPLOYEE # K2742 EFFECTIVE DATE 30 017 SECTION 2: TYPE OF ACTION 7 V I EMPLOYEE TYPE ❑� FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) EMPLOYEE ACTION TYPE OF SEPARATION ❑ DISCHARGE (D) ❑ RESIGNATION (Q) ❑ RETIRED (R) ❑ LAID OFF (L) ❑ FAIL PROBATION (P) ❑ OTHER (0) REASON FOR SEPARATION ❑ NEW HIRE ❑ RE -HIRE N-RIT/STEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) TERMINATION (Provide Separation Info) 1� OTHER (Describe Below) ❑ PERFORMANCE (P) ❑ ATTENDANCE (A) ❑ CONDUCT (C) ❑ OTHER EMPLOYMENT (E) ❑ PERSONAL (L) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Increase per wage survey - payment effective 1/1/17; deferred until February payroll. SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data ReportEnter new data JOB TITLE WEB DEVELOPER OCCUPATION CODE 2365 UNION CODE 40 PAY GRADE 265 STEP / POSITION 7 FLSA STATUS E] Non -Exempt ❑ Exempt ❑ Not Covered 0 Non -Exempt ❑ Exempt [:]Not Covered DRS STATUS ❑ Ineligible 0 PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible Q PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 1/3/2017 ADJ HIRE DATE 1/3/2017 POSITION DATE 1/3/2017 LAST RAISE DATE BASE WAGE $4,040.00 4,703.00 LONGEVITY $ 0.00 $ FTE ❑p 100% ❑ 80% [175% ❑ 60% ❑ 50% p 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $4,040.00 $4,703.00 PAYMENT METHOD ❑ HOURLY ❑� MONTHLY ❑ HOURLY F] MONTHLY DEPARTMENT INFORMATION TECHNOLOGY BUDGET NUMBER A. %: A. %: B. %: B. %: WORKWEEK ❑� Standard ❑ ALT/I" Friday off: ❑ 207(k) ❑� Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $ 0,00 $ 0.00 STIPEND (Detail in Comments Section) $ 0,00 $ 0.00 OTHER (Detail in Comments Section) $ 0,00 $ 0.00 SECTION 4: SIGNATURES( UST BE SIGNED IN BLUE INK) DEP Q ' ECTED OFFICIAL PATE !!!7 BUDGET/PAVPCILL 2- 7/5 H MAH AESOUkt— u L LDATV 'I COM i DATE CM 112 DATE COM 10N I � 7E RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update Eval Date Eval Rating (IE–ID–S–AA–S) Initial KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) SECTION 1: EMPLOYEE DATA LAST NAME FIRST NAME EMPLOYEE # EFFECTIVE DATE Lee Calvin L2613 7 SECTION 3: POSITION DATA SECTION 2: TYPE OF ACTION ' r . EMPLOYEE TYPE I EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION 1 1 FULL-TIME (1) ❑ NEW HIRE 40 ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ PART-TIME (2) RE -HIRE 6 ❑ RESIGNATION (C.) ❑ ATTENDANCE (A) ❑ LIMITED PART-TIME (3) -RNERST / STEP ❑ Ineligible ❑� PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ RETIRED (R) ❑ CONDUCT (C) ❑ TEMPORARY (4) ❑ POSITION CHANGE (Describe Below) ADJ HIRE DATE ❑ LAID OFF (L) ❑OTHER EMPLOYMENT (E) ❑ CASUAL (5) ❑ BUDGET CHANGE (Describe Below) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ SEASONAL (6) ❑ LEAVE (List Type Below) BASE WAGE ❑ OTHER (0) ❑ OTHER (0) ❑ PROJECT (7) ❑ TERMINATION (Provide Separation Info) $ 0.00 $ FTE ❑ WORK STUDY (8) 'OTHER (Describe Below) FTE WAGE ❑ Eligible For Rehire ❑ Ineligible For Rehire ❑ VOLUNTEER (9) ❑ HOURLY ❑� MONTHLY ❑ HOURLY ❑� MONTHLY Provide Details of Separation Below COMMENTS. Increase per wage survey -payment effective deferred until February payroll. BUDGET NUMBER �� :�'7 R �.�.I'iVll�.�t•�i,�. rl_/1/17; � ��U1r�i-�l�.t<� �if�Lf WORKWEEK I] Standard ❑ ALT/1s` Friday off: ❑ 207(k) SECTION 3: POSITION DATA To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount win aerauit to -"u--, ALLOWANCE (Detail in Comments Section) $ 60.00 $ 60.00 STIPEND (Detail in Comments Section) $ 0.00 $ 0.00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES( UST BE SIGNED IN BLUE INK) DF.PARTMENY, HEAp•% ELECTED OFFICIAL DATE BUDGET AYR L - HU AV RE46UW r E DATt COMMISSIO ` C M R q2DATE COMMI i k-3�' RETURN FORM TO HUMAN RESO ACES FORu'0iSTRi6UTf0N Updated: 04/08/11 FOR HR USE: NT Update Eval Date Eval Rating (IE—ID—S—AA—S) Initial Enter existing data/rare CAMAS Wage Data Report Enter new data JOB TITLE SERVICE DESK SPECIALIST OCCUPATION CODE 2451 UNION CODE 40 PAY GRADE 251 STEP / POSITION 6 FLSA STATUS [] Non -Exempt ❑ Exempt ❑ Not Covered ❑E Non -Exempt ❑ Exempt ❑ Not Covered DRS STATUS ❑ Ineligible ❑� PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible ❑' PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 4/1/2015 ADJ HIRE DATE 4/1/2015 POSITION DATE 4/1/2015 LAST RAISE DATE 1/1/2016 1111 1 7� BASE WAGE $ 3,482.00 $ 3.624M LONGEVITY $ 0.00 $ FTE ❑� 100% [:180% ❑ 75% ❑ 60% [:150% [] 100% [:180% ❑ 75% [:160% ❑50% FTE WAGE $ 3,482.00 $ 3,924.00 PAYMENT METHOD ❑ HOURLY ❑� MONTHLY ❑ HOURLY ❑� MONTHLY DEPARTMENT INFORMATION TECHNOLOGY BUDGET NUMBER A. 001 000000000001751001 %: 100.00 B. %: A. %: B. %: WORKWEEK I] Standard ❑ ALT/1s` Friday off: ❑ 207(k) ❑� Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount win aerauit to -"u--, ALLOWANCE (Detail in Comments Section) $ 60.00 $ 60.00 STIPEND (Detail in Comments Section) $ 0.00 $ 0.00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES( UST BE SIGNED IN BLUE INK) DF.PARTMENY, HEAp•% ELECTED OFFICIAL DATE BUDGET AYR L - HU AV RE46UW r E DATt COMMISSIO ` C M R q2DATE COMMI i k-3�' RETURN FORM TO HUMAN RESO ACES FORu'0iSTRi6UTf0N Updated: 04/08/11 FOR HR USE: NT Update Eval Date Eval Rating (IE—ID—S—AA—S) Initial C -,K KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) LAST NAME Tushkov SECTION 1: EMPLOYEE DATA FIRST NAME EMPLOYEE #EFFECTIVE DATE Tyler T2351 rt 7 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE ❑✓ FULL-TIME (1) ❑ PART-TIME (2) ❑ LIM ITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ❑ NEW HIRE ❑ R •HIRE❑ R IT / STEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) IERMINATION (Provide Separation Info) OTHFR (Describe Below) ❑ DISCHARGE (D) RESIGNATION (Q) ❑ RETIRED (R) ❑ LAID OFF (L) ❑ FAIL PROBATION (P) ❑ OTHER (0) ❑ PERFORMANCE (P) ❑ ATTENDANCE (A) ❑ CONDUCT (C) ❑ OTHER EMPLOYMENT (E) ❑ PERSONAL (L) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS. Increase per wage survey - payment effective 1/1/17; deferred until February payroll. SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data ReportEnter new data JOB TITLE SERVICE DESK SPECIALIST OCCUPATION CODE 2451 UNION CODE 40 PAY GRADE 251 STEP / POSITION 5 FLSA STATUS ❑� Non -Exempt ❑ Exempt ❑ Not Covered Non -Exempt ❑ Exempt ❑ Not Covered DRS STATUS ❑ Ineligible ❑� PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible ❑� PERS ❑ LEOFF ❑ P5ERS ❑ Other HIRE DATE 1/2/2013 ADJ HIRE DATE 1/2/2013 POSITION DATE 1/2/2013 LAST RAISE DATE 1/1/2016 1 } BASE WAGE $3,962.00 $4,552.00 LONGEVITY $ 0.00 $ FTE [] 100% ❑ 80% ❑ 75% ❑ 60% [:150% ❑' 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $3,962.00 $4,552.00 PAYMENT METHOD ❑ HOURLY ❑� MONTHLY ❑ HOURLY ❑� MONTHLY DEPARTMENT INFORMATION TECHNOLOGY BUDGET NUMBER A. 001 000000000001751001 %: 100.00 A. %: B. %: B. %: WORKWEEK ❑' Standard ❑ ALT/15t Friday off:❑ 207(k) ❑� Standard ❑ALT/1" Friday off: [I207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $ 60.00 $ 60.00 STIPEND (Detail in Comments Section) $ 0.00 $ 0.00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES (MUST BE SIGNED IN BLUE INK) DEPJ�RurvifiNVftq / ELECTED OFFICIALATE --)- 1 BUDGET/PAYRQ )DAT '� � Iv,�7�/ HCIAN ES - T�T l COMMISSIO DATE COMMIS. DA 4QG00 C i R #2 DATE 2 ►� -J RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update Eva IDate EvalRating(IE—ID—S—AA—S) Initial N C� w KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) crrTIr)N 1 • FMDI r1VFF naTA LAST NAME Adams FIRST NAME Cindy EMPLOYEE # A1161 EFFECTIVE DATE 01/01/2017 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ❑� FULL-TIME (1) ❑ PART-TIME (2) 1711-1 M ITE D PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE e V►ERRMP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) TERMINATION (Provide Separation Info) It ER (Describe Below) ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ RETIRED (R) ❑ CONDUCT (C) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ OTHER (0) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS; WAGE INCREASE PER SALARY SURVEY — P CL J M CYI-} eiRerp+i J-Lj dt 4erre. A Olv)+i i F2h p�n�rcll Uilrl SECTION 3: POSITION DATA JOB TITLE Enter existing data from CAMAS Wage Data Report Enter new data ADMINISTRATIVE ASSISTANT III OCCUPATION CODE 3376 UNION CODE 30 PAY GRADE 376 STEP / POSITION 5 FLSA STATUS ❑ Non -Exempt ❑� Exempt ❑ Not Covered ❑ Non -Exempt 0 Exempt ❑ Not Covered DRS STATUS ❑ Ineligible ❑� PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible ❑� PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 2/11/1998 ADJ HIRE DATE 2/11/1998 POSITION DATE 1/30/2007 LAST RAISE DATE 1/1/2016 BASE WAGE $3,970.00 $4,268.00 LONGEVITY $ 0.00 $ FTE E 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% ❑� 100% ❑ 80% [175% ❑ 60% ❑ 50% FTE WAGE $ 3,970.00 $ 4,268.00 PAYMENT METHOD ❑ HOURLY E MONTHLY ❑ HOURLY ❑� MONTHLY DEPARTMENT ASSESSOR BUDGET NUMBER A. 001 000000000001051001 %: 100.00 A. %: B. %: B. %: WORKWEEK ❑' Standard ❑ ALT/1" Friday off: ❑ 207(k) ❑� Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "O". ALLOWANCE (Detail in Comments Section) $ 0.00 $ 0.00 STIPEND (Detail in Comments Section) $ 0,00 $ 0.00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES (MUST BE SIGNED.i BLUE INK) DEP T f Hb)P/ELECTED Of lc l' DATE BUDGETJPAYR61_1. DATE H A RESOURCE N� DATE DA E 2-3 COMMI55 COMMI DA / RETURN FORM TO HUMAN RESOUR ES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update Eval Date Eval Rating (IE -ID -S -AA -S) Initial KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) 4 SECTION 1: EMPLOYEE DATA LAST NAME FIRST NAME EMPLOYEE # EFFECTIVE DATE Vavricka � Zach V2605 01/01/2017 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE F.rrmerexisbng data from CAMASWoQe Data Report EMPLOYEE ACTION JOB TITLE TYPE OF SEPARATION REASON FOR SEPARATION ❑ FULL-TIME (1) 2433 ❑ NEW HIRE UNION CODE [] DISCHARGE (D) ❑ PERFORMANCE (P) Q PART-TIME (2) 233 ❑ RE -HIRE STEP / POSITION ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ LIMITED PART-TIME (3) 0 Non -Exempt []Exempt ❑ Not Covered ❑ MERIT/ STEP DRS STATUS ❑ RETIRED (R) ❑ CONDUCT (C) ❑ TEMPORARY (4) 4/6/2015 ❑ POSITION CHANGE (Describe Below) ADJ HIRE DATE ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ CASUAL (5) 4/6/2015 ❑ BUDGET CHANGE (Describe Below) LAST RAISE DATE ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ SEASONAL (6) BASE WAGE ❑ LEAVE (List Type Below) $'1,M4.50 ' ❑ OTHER (0) ❑ OTHER (0) ❑ PROJECT (7) FTE ❑ TERMINATION (Provide Separation Info) ❑ 100% ❑ 80% ❑ 75% ❑ 60% 50% FTE WAGE $ 3,483.00 ❑ WORK STUDY (8) PAYMENT METHOD Q OTHER (Describe Below) ❑ HOURLY MONTHLY ❑ Eligible For Rehire ❑ Ineligible For Rehire ❑ VOLUNTEER (9) BUDGET NUMBER A. 116 000000006121151001 %: 100.00 B, %: A. %: B. %: Provide Details of Separation Below COMMENTS: Increase per wage survey -payment effective 1/1/17; deferred until February payroll. SECTION 3: POSITION DATA To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". F.rrmerexisbng data from CAMASWoQe Data Report Enter new data JOB TITLE HEALTH PROMOTION SPECIALIST I $ 0.00 OCCUPATION CODE 2433 $ 0.00 UNION CODE 40 SECTION 4: SIGNATURES IMUST BE SIGNED IN BIJUIE PAY GRADE 233 STEP / POSITION 6 BUDGET/PAYROLL FLSA STATUS 0 Non -Exempt []Exempt ❑ Not Covered Non -Exempt ❑ Exempt ❑ Not Covered DRS STATUS ❑ Ineligible ❑� PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible M PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 4/6/2015 ADJ HIRE DATE 4/6/2015 Updated: 04/08/11 FOR HR USE: POSITION DATE 4/6/2015 LAST RAISE DATE 1/1,12016 _ BASE WAGE $1,741.50 $'1,M4.50 ' LONGEVITY $ 0.00 $ FTE ❑ 100% ❑ 80% ❑ 75% ❑ 60% 2 50% ❑ 100% ❑ 80% ❑ 75% ❑ 60% 50% FTE WAGE $ 3,483.00 $ 3,729.00 PAYMENT METHOD ❑ HOURLY ❑� MONTHLY ❑ HOURLY MONTHLY DEPARTMENT PUBLIC HEALTH BUDGET NUMBER A. 116 000000006121151001 %: 100.00 B, %: A. %: B. %: WORKWEEK ❑� Standard ❑ ALT/1" Friday off: ❑ 207(k) Standard ❑ ALT/1s` Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $ 0.00 $ 0.00 STIPEND (Detail in Comments Section) $ 0.00 $ 0.00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES IMUST BE SIGNED IN BIJUIE INK) D ENT IAL D BUDGET/PAYROLL H MAN RESOURCE DATE COMMI55i C E #2 DATE i COMMI 3 RETURN FORM TO HUMA9 RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update Eval Date EvalRating(IE—ID—S—AA—S) Initial KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) Updated: 04/08/11 FOR HR USE: NT Update -- Eval Date Eval Rating (IE — ID — S — AA — S) Initial SECTION 1: EMPLOYEE DATA LAST NAME Boots FIRST NAME Kathy EMPLOYEE # B2116 EFFECTIVE DATE 01/01/2017 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ✓❑ FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE ❑ MERIT/ STEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ❑ TERMINATION (Provide Separation Info) OTHER (Describe Below) ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ RETIRED (R) ❑ CONDUCT (C) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ OTHER (0) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Increase per wage survey - payment effective 1/1/17; deferred until February payroll. SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE PERMIT TECHNICIAN OCCUPATION CODE 2441 UNION CODE 40 PAY GRADE 241 STEP / POSITION 5 FLSA STATUS ❑' Non -Exempt ❑ Exempt ❑ Not Covered [j] Non -Exempt [:]Exempt ❑Not Covered DRS STATUS ❑ Ineligible Q PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible [E PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 8/29/2008 ADJ HIRE DATE 8/29/2008 POSITION DATE 9/21/2015 LAST RAISE DATE 1/1/2016 BASE WAGE $ 3,505.00 $ 4,156.00 LONGEVITY $ 0.00 $ FTE ❑' 100% [:]80% ❑ 75% ❑ 60% ❑ 50% ❑' 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $ 3,505.00 $ 4,156.00 PAYMENT METHOD ❑ HOURLY ❑' MONTHLY ❑ HOURLY '❑ MONTHLY DEPARTMENT COMMUNITY DEVELOPMENT SERVICES BUDGET NUMBER A. 402 000000104201051001 %: 100.00 B. X.. A. Vis: B. %: WORKWEEK E] Standard ❑ ALT/1" Friday off: ❑ 207(k) El Standard ❑ ALT/1" Friday off: __ ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $ 0.00 $ 0.00 STIPEND (Detail in Comments Section) $ 0.00 $ 0.00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES (MUST BE SIGNED IN BLUE INK) TMENT /F.LECTTDOFFICIAL DAT J I BUDGET/P O ITE HUMAN RESOURCE UAE - o-,11 COMMISS DATE CO N 2 HATE COM E 5ATr RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTIO Updated: 04/08/11 FOR HR USE: NT Update -- Eval Date Eval Rating (IE — ID — S — AA — S) Initial 011 KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) SECTION 1: EMPLOYEE DATA LAST NAME Keith FIRST NAME Sarah EMPLOYEE # K1526 EFFECTIVE DATE 01/01/2017 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ❑� FULL-TIME (1) ❑ NEW HIRE ❑ DISCHARGE (D) _E1 PERFORMANCE (P) ❑ PART-TIME (2) ❑ RE -HIRE ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ LIMITED PART-TIME (3) ❑ MERIT/ STEP ❑ RETIRED (R) ❑ CONDUCT (C) ❑ TEMPORARY (4) ❑ POSITION CHANGE (Describe Below) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ CASUAL (5) ❑ BUDGET CHANGE (Describe Below) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ SEASONAL (6) ❑ LEAVE (List Type Below) ❑ OTHER (0) ❑ OTHER (0) ❑ PROJECT (7) ❑ TERMINATION (Provide Separation Info) ❑ WORK STUDY (8) ❑✓ OTHER (Describe Below) ❑ Eligible For Rehire ❑ Ineligible For Rehire ❑ VOLUNTEER (9) Provide Details of Separation Below COMMENTS: Increase per wage survey - payment effective 1/1/17; deferred until February payroll. 103 \\ v 1 p p, a SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE SUPERIOR COURT ADMIN SUPERIOR COURT ADMIN OCCUPATION CODE 1319 1319 UNION CODE 30 30 PAY GRADE 119 119 STEP / POSITION 5 5 FLSA STATUS ❑ Non -Exempt 0 Exempt ❑ Not Covered ❑ Non -Exempt 0 Exempt ❑ Not Covered DRS STATUS ❑ Ineligible [j] PERS ❑ LEOFF [:1 PSERS ❑ Other ❑ Ineligible E] PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 5/8/2003 5/8/2003 ADJ HIRE DATE 5/8/2003 5/8/2003 POSITION DATE 8/3/2015 8/3/2015 LAST RAISE DATE 1/1/2016 1/1/17 BASE WAGE $4,303.00 $5,675.00 LONGEVITY $ 0.00 $ 0 FTE ❑� l00% ❑ 80% ❑ 75% [:160% ❑50% 0 l00% ❑ 80% [175% ❑60% ❑ 50% FTE WAGE $4,303.00 $5,675.00 PAYMENT METHOD ❑ HOURLY ❑� MONTHLY ❑ HOURLY Q MONTHLY DEPARTMENT SUPERIOR COURT SUPERIOR COURT BUDGET NUMBER A. 001 000000000002151001 B. %: 100.00 A. 001 000000000002151001 %: 100 %: B. %: WORKWEEK 0 Standard ❑ ALT/1" Friday off: ❑ 207(k) 0 Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to '0". ALLOWANCE (Detail in Comments Section) $ 0.00 $ 0.00 STIPEND (Detail in Comments Section) $ 25.00 $ 25.00 OTHER (Detail in Comments Section) $ 855.25 $ 0.00 SECTION 4: SIGNATURES (MUST BE SIGNED IN BLUE INK) ART W A J EDOFFICIA DATE BUDGE PAY 61 LI. DAT HYMAN RESOURCE DATE C[)Idl ' E COL MI' I N DATE COMMF ` AT RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update EvalDate Eval Rating (IE—ID—S—AA—S) Initial x KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) LAST NAME Luvera SECTION 1: EMPLOYEE DATA FIRST NAME EMPLOYEE # EFFECTIVE DATE Christine L0204 01/01/2017 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ❑✓ FULL-TIME (1) ❑ NEW HIRE ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ PART-TIME (2) ❑ RE -HIRE ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ LIMITED PART-TIME (3) ❑ MERIT /STEP ❑ RETIRED (R) ❑ CONDUCT (C) ❑ TEMPORARY (4) ❑ POSITION CHANGE (Describe Below) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ CASUAL (5) ❑ BUDGET CHANGE (Describe Below) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ SEASONAL (6) ❑ LEAVE (List Type Below) ❑ OTHER (0) ❑ OTHER (0) ❑ PROJECT (7) ❑ TERMINATION (Provide Separation Info) ❑ WORK STUDY (8) ❑✓ OTHER (Describe Below) ❑ Eligible For Rehire ❑ Ineligible For Rehire ❑ VOLUNTEER (9) Provide Details of Separation Below COMMENTS: Increase per wage survey - payment effective 1/1/17; deferred until February payroll. SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE DISTRICT COURT ADMIN OCCUPATION CODE 1310 UNION CODE 30 PAY GRADE 110 STEP / POSITION 5 FLSA STATUS ❑ Non -Exempt 0 Exempt ❑ Not Covered ❑ Non -Exempt Q Exempt ❑ Not Covered DRS STATUS ❑ Ineligible 0 PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible Q PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 6/14/2002 ADJ HIRE DATE 5/1/2006 POSITION DATE 4/1/2007 LAST RAISE DATE 1/1/2016 ,� BASE WAGE $ 5,090.00 $ 5,599.00 LONGEVITY $ 0.00 $ FTE Q 100/ ❑ 80% [175% ❑ 60% ❑ 50/ ❑' 100/ ❑ 80% E175% ❑ 60% ❑ 50% FTE WAGE $ 5,090.00 $ 5,599.00 PAYMENT METHOD ❑ HOURLY 0 MONTHLY ❑ HOURLY ❑� MONTHLY DEPARTMENT LOWER DISTRICT COURT BUDGET NUMBER A. 001 000000000002451001 is 100.00 B. %: A. %: B. %: WORKWEEK Q Standard ❑ ALT/1" Friday off: ❑ 207(k) 0 Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $ 0.00 $ 0.00 STIPEND (Detail in Comments Section) $ 0.00 $ 0.00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES (MUST BE SIGNED IN BLUE INK) DEPART ENT E ED OFFICIAL DATE BUDGET/PAYR DA E 4U1,6AN RE OUR ATE COMMI 2 C E 11Z DATE COM DATE 70" RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update Eval Date Eval Rating (IE — ID — S — AA — S) Initial C KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) SECTION 1: EMPLOYEE DATA LAST NAME FIRST NAME EMPLOYEE # EFFECTIVE DATE Schoos Rebecca 52442 1-1-17 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE _ l EMPLOYEE ACTION TYPE OF SEPARATION _I REASON FOR SEPARATION ® FULL-TIME (1)0 NEW HIRE ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ PART-TIME (2) ❑ RE -HIRE ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ LIMITED PART-TIME (3) 0 MERIT/ STEP ❑ RETIRED (R) ❑ CONDUCT (C) ❑ TEMPORARY (4) ❑ POSITION CHANGE (Describe Below) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ CASUAL (5) ❑ BUDGET CHANGE (Describe Below) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ SEASONAL (6) ❑ LEAVE (List Type Below) ❑ OTHER (0) ❑ OTHER (0) ❑ PROJECT (7) ❑ TERMINATION (Provide Separation Info) ❑ WORK STUDY (8) ® OTHER (Describe Below) ❑ Eligible For Rehire ❑ Ineligible For Rehire ❑ VOLUNTEER (9) Provide Details of Separation Below COMMENTS: Increase per wage survey- effective 1-1-17; deferred until February payroll SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE LS II OCCUPATION CODE 3405 UNION CODE 40 PAY GRADE 305 STEP / POSITION 5 FLSA STATUS ® Non -Exempt ❑ Exempt ❑ Not Covered ® Non -Exempt ❑ Exempt ❑ Not Covered DRS STATUS ❑ Ineligible ® PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible Qg PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 6-10-13 ADJ HIRE DATE 6-10-13 POSITION DATE 6-10-13 LAST RAISE DATE 7-1-16 1-1-17 BASE WAGE $3207 $3367 _ LONGEVITY $0 $ FTE ® 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $3207 $3367. PAYMENT METHOD ❑ HOURLY ® MONTHLY ❑ HOURLY q MONTHLY DEPARTMENT Prosecutor BUDGET NUMBER A.00129035 ) 001 /:100. , A. _ r: B. %: B. %: WORKWEEK ® Standard ❑ ALT/1" Friday off: ❑ 207(k) ❑ Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $0 $ STIPEND (Detail in Comments Section) $0 $ OTHER (Detail in Comments Section) so $ SE ON 4: SIGNATURES {h4UIST BE SIGNED N -S UE INK) DEPA 7 HEAD/E ED FFICIAL DATE BUDGET/PAY L DATE L HU DATE T COMMISSI E ' O Jit •i DATE COMMI DAT RETURN FORM TO HUMAN RESOURCES FOR DISTRIBU N Updated: 04/08/11 FOR HR USE: NT Update Eval Date Eval Rating (IE—ID—S—AA—S) Initial Mal KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) Updated: 04/08/11 FOR HR USE: NT Update EvalDate Eval Rating (IE—ID—S—AA—S) Initial SECTION 1: EMPLOYEE DATA LAST NAME FIRST NAME EMPLOYEE # EFFECTIVE DATE Blackwood Jessie B1757 1-1-17 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ® FULL-TIME (1) ❑ NEW HIRE ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ PART-TIME (2) ❑ RE -HIRE ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ LIMITED PART-TIME (3) ❑ MERIT/ STEP ❑ RETIRED (R) ❑ CONDUCT (C) ❑ TEMPORARY (4) ❑ POSITION CHANGE (Describe Below) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ CASUAL (5) ❑ BUDGET CHANGE (Describe Below) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ SEASONAL (6) ❑ LEAVE (List Type Below) ❑ OTHER (0) ❑ OTHER (0) ❑ PROJECT (7) ❑ TERMINATION (Provide Separation Info) ❑ WORK STUDY (8) ® OTHER (Describe Below) Eligible For Rehire ❑ Ineligible For Rehire ❑ VOLUNTEER (9) Provide Details of Separation Below COMMENTS: Increase per wage survey- payment effective 1-1-17; deferred to February payroll. SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE LS I OCCUPATION CODE _342_9 UNION CODE 40 PAY GRADE 329 STEP / POSITION 5 FLSA STATUS ® Non -Exempt ❑ Exempt ❑ Not Covered Non -Exempt ❑ Exempt ❑ Not Covered DRS STATUS ❑ Ineligible ® PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 6-21-05 ADJ HIRE DATE 3-29-10 POSITION DATE 1-1-13 LAST RAISE DATE 1-1-16 1-1-17 BASE WAGE $2850. $2993. LONGEVITY $0 $0 FTE ® 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $2850 $2993 PAYMENT METHOD ❑ HOURLY ® MONTHLY ❑ HOURLY RMONTHLY DEPARTMENT Prosecutor BUDGET NUMBER A.001290151001 %:100 A. %: B. %: B. %: WORKWEEK ❑ Standard ® ALT/1" Friday off: ❑ 207(k) ❑ Standard ❑ ALT/V Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $0 $ STIPEND (Detail in Comments Section) $0 $ OTHER (Detail in Co ents Section) $0 $ SECTION 4: SIGNATURES (MUST BE SIGNED IN BLUE INK) DEPARTM. H D/ ELECTED OFFI IA DA7f. BUDGET/PAYROL f D 7E �. ;I 3 1l HUMA ES0 DATE COMMI11lO D E 2, I7 CO DATE COMMISS 2ATE RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update EvalDate Eval Rating (IE—ID—S—AA—S) Initial U 'KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) LAST NAME Burroughs SECTION 1: EMPLOYEE DATA FIRST NAME EMPLOYEE # EFFECTIVE DATE Theresa L2417 1-1-17 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ® FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE ❑ MERIT/ STEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ❑ TERMINATION (Provide Separation Info) ® OTHER (Describe Below) ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ RETIRED (R) ❑ CONDUCT (C) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ OTHER (0) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Increase per wage survey- Effective 1-1-17; deferred until February payroll SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE LS I OCCUPATION CODE 3429 UNION CODE 40 PAY GRADE 329 STEP / POSITION 5 FLSA STATUS ® Non -Exempt ❑ Exempt ❑ Not Covered W Non -Exempt ❑ Exempt ❑ Not Covered DRS STATUS ❑ Ineligible ® PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible @ PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 1-22-13 ADJ HIRE DATE 1-22-13 POSITION DATE 1-1-14 LAST RAISE DATE 1-1-16 1-1-17 BASE WAGE $2758. $2896. LONGEVITY $0 $ FTE ® 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $2758 $2896 PAYMENT METHOD ❑ HOURLY ® MONTHLY ❑ HOURLY 14 MONTHLY DEPARTMENT Prosecutor BUDGET NUMBER A.001290151001 %:100 B. %: A. %: B. %: WORKWEEK ❑ Standard ® ALT/1" Friday off: ❑ 207(k) ❑ Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0", ALLOWANCE (Detail in Comments Section) $0 $ STIPEND (Detail in Comments Section) $0 $ OTHER (Detail in Comments Section) $0 $ SECTlq", : SIGNATURES (MUST BE SIGNED IN B INK) DEPA EAD/ELECTE O At DATE BUDGET/PAYROLL TE -7� 11 HUMAN�kSD £` DATE COMMISSION D TE CO 2 DATE COMMiSSI i3 A E RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update EvalDate EvalRating (IE—ID—S—AA—S) Initial C� '. KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) LAST NAME Bugni SECTION 1: EMPLOYEE DATA FIRST NAME EMPLOYEE # EFFECTIVE DATE Angela B 163 6 1-1-17 EMPLOYEE TYPE SECTION 2: TYPE OF ACTION EMPLOYEE ACTION TYPE OF SEPARATION 1 REASON FOR SEPARATION ® FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) 0 CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE ❑ MERIT/ STEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ❑ TERMINATION (Provide Separation Info) ® OTHER (Describe Below) ❑ DISCHARGE (D) ❑ RESIGNATION (Q) ❑ RETIRED (R) ❑ LAID OFF (L) ❑ FAIL PROBATION (P) ❑ OTHER (0) ❑ PERFORMANCE (P) ❑ ATTENDANCE (A) ❑ CONDUCT (C) ❑ OTHER EMPLOYMENT (E) ❑ PERSONAL (L) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Increase per wage survey. Effectivel-1-17; deferred until February payroll. SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE LS III OCCUPATION CODE 3410 UNION CODE 40 PAY GRADE 310 STEP / POSITION 5 FLSA STATUS ® Non -Exempt ❑ Exempt ❑ Not Covered Non -Exempt ❑ Exempt ❑ Not Covered DRS STATUS ❑ Ineligible ® PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible DJ PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 8-9-2004 ADJ HIRE DATE 8-9-2004 POSITION DATE 4-15-2003 LAST RAISE DATE 1-1-17 BASE WAGE $3510. $3773. LONGEVITY $0 $ FTE ® 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% ® 100% ❑ 80% ❑ 75% ❑ 60% ❑ 509 FTE WAGE $3510 $3773. PAYMENT METHOD ❑ HOURLY ® MONTHLY ❑ HOURLY ® MONTHLY DEPARTMENT Prosecutor BUDGET NUMBER A.001290351001 %:100 B. %: A. is B. %: WORKWEEK ® Standard ❑ ALT/1" Friday off: ❑ 207(k) ® Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0", ALLOWANCE (Detail in Comments Section) $0 $ STIPEND (Detail in Comments Section) $0 $ OTHER (Detail in Comments Section) $0 $ SEg1GN 4: SIGNATURES (MUST BE SIGNED I LUE INK) DEPA EAD /ELECTED F CIAL _ DATE BUDGET/PAYROLL DD TE HU AN RE$¢F! DATE COMMISSID DAT 2_2 .191/7F COA tt2 ATE k3 %�r COMMiSS R �} / /DATE r T v�-1 RETURN FORM TO HUMAN RESOUR S FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update Eval Date EvalRating(IE— ID—S—AA—S) Initial C�- KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) LAST NAME Fritz EMPLOYEE TYPE SECTION 1: EMPLOYEE DATA FIRST NAME EMPLOYEE # EFFECTIVE DATE Ramona A 12 2 2 1-1-17 SECTION 2: TYPE OF ACTION I EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION , — ® FULL-TIME (1) ❑ NEW HIRE ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ PART-TIME (2) ❑ RE -HIRE ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ LIMITED PART-TIME (3) ❑ MERIT/ STEP ❑ RETIRED (R) ❑ CONDUCT (C) ❑ TEMPORARY (4) ❑ POSITION CHANGE (Describe Below) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ CASUAL (5) ❑ BUDGET CHANGE (Describe Below) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ SEASONAL (6) ❑ LEAVE (List Type Below) ❑ OTHER (0) ❑ OTHER (0) ❑ PROJECT (7) ❑ TERMINATION (Provide Separation Info) ❑ WORK STUDY (8) ® OTHER (Describe Below) ❑ Eligible. For Rehire ❑.Ineligible For Rehire ❑ VOLUNTEER (9) Provide Details of Separation Below COMMENTS: Increase per wage survey- effective 1-1-17; deferred unti 1 February payroll SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE LS II OCCUPATION CODE 3405 UNION CODE 40 PAY GRADE 305 STEP / POSITION 6 FLSA STATUS ® Non -Exempt ❑ Exempt ❑ Not Covered Non -Exempt ❑ Exempt [:]Not Covered DRS STATUS ❑ Ineligible ® PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible IxPERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 1-19-99 ADJ HIRE DATE 1-19-99 POSITION DATE 5-1-04 LAST RAISE DATE 1-1-16 1-1-17 BASE WAGE $3454. $3799. LONGEVITY $0 $ FTE ® 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% 14 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $3454 $3799 PAYMENT METHOD ❑ HOURLY ® MONTHLY ❑ HOURLY 03 MONTHLY DEPARTMENT BUDGET NUMBER Prosecutor A.001290151001 /:100 B. %: A. is B. %: WORKWEEK ❑ Standard ® ALT/1" Friday off: ❑ 207(k) ❑ Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $0 $ STIPEND (Detail in Comments Section) $0 $ OTHER (Detail in Comments Section) $0 $ SECTI N 4: SIGNATURES (MUST BE SIGNS LUE INK) DEP.ARTM AD / ELE DO IA -L DATE I BUDGET/PAY oLL DAT /1 HUMAJN R DATE COMMISSIO 1 / D 7E CO 2 DATE Commi55 E RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update Eval Date Eval Rating (IE—ID—S—AA—S) Initial KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) Updated: 04/08/11 FOR HR USE: NT Update Eval Date Eval Rating (IE—ID—S—AA—S) Initial SECTION 1: EMPLOYEE DATA LAST NAME FIRST NAME EMPLOYEE # EFFECTIVE DATE Davison dUSTIN d2485 1-1-17 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ® FULL-TIME (1) ❑ NEW HIRE ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ PART-TIME (2) ❑ RE -HIRE ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ LIMITED PART-TIME (3) ❑ MERIT/ STEP ❑ RETIRED (R) ❑ CONDUCT (C) ❑ TEMPORARY (4) ❑ POSITION CHANGE (Describe Below) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ CASUAL (5) ❑ BUDGET CHANGE (Describe Below) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ SEASONAL (6) ❑ LEAVE (List Type Below) ❑ OTHER (0) ❑ OTHER (0) ❑ PROJECT (7) ❑ TERMINATION (Provide Separation Info) ❑ WORK STUDY (8) ® OTHER (Describe Below) ❑ Eligible For Rehire ❑ Ineligible For Rehire ❑ VOLUNTEER (9) Provide Details of Separation Below COMMENTS: Increase per wage survey- effective 1-1-17; deferred until February payroll SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE LS I _ OCCUPATION CODE 3429 UNION CODE 40 PAY GRADE 329 STEP / POSITION 5 FLSA STATUS ® Non -Exempt ❑ Exempt ❑ Not Covered Non -Exempt ❑ Exempt ❑ Not Covered DRS STATUS ❑ Ineligible ® PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible [g PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 12-23-13 ADJ HIRE DATE 12-23-13 POSITION DATE 9-1-14 LAST RAISE DATE 1-1-16 1-1-17 BASE WAGE $2758 $2896. LONGEVITY $0 $ FTE ® 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% 0100%E] 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $2758 $2896. PAYMENT METHOD ❑ HOURLY ® MONTHLY ❑ HOURLY in MONTHLY DEPARTMENT Prosecutor BUDGET NUMBER A.O01290151O01 %:100 A. %: B. %: B. %: WORKWEEK ® Standard ❑ ALT/I" Friday off: ❑ 207(k) ❑ Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $0 $ STIPEND (Detail in Comments Section) $0 $ OTHER (Detail in Comments Section) $0 $ SECTION 4: SIGNATURES (MUST BE SIGNED UE INK) DEPART EAD / ELECT O CIAL DATE BUDGET/PAYR LL p E HUM N RESO RCE DATE CAMMI5510 ❑ TE CO 112 DATE COMMI E r E _ X1.3 -J RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update Eval Date Eval Rating (IE—ID—S—AA—S) Initial C4 KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) LAST NAME Howard SECTION 1: EMPLOYEE DATA FIRST NAME EMPLOYEE # EFFECTIVE DATE Kathleen H1971 1-1-17 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ® FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE ❑ MERIT/ STEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ❑ TERMINATION (Provide Separation Info) ® OTHER (Describe Below) ❑ DISCHARGE (D) ❑ RESIGNATION (Q) ❑ RETIRED (R) ❑ LAID OFF (L) ❑ FAIL PROBATION (P) ❑ OTHER (0) ❑ PERFORMANCE (P) ❑ ATTENDANCE (A) ❑ CONDUCT (C) ❑ OTHER EMPLOYMENT (E) ❑ PERSONAL (L) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Increase per wage survey- effective 1-1-17; deferred until February payroll SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE SE Paralegal OCCUPATION CODE 2418 UNION CODE 40 PAY GRADE 218 STEP / POSITION 5 FLSA STATUS ® Non -Exempt ❑ Exempt ❑ Not Covered Non -Exempt ❑ Exempt ❑ Not Covered DRS STATUS ❑ Ineligible ® PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible Q PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 5-7-07 ADJ HIRE DATE 5-7-07 POSITION DATE 1-1-13 LAST RAISE DATE 1-1-16 1-1-17 BASE WAGE $3433 $3733. LONGEVITY $0 $ FTE ® 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% ® 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $3433 $3733. PAYMENT METHOD ❑ HOURLY ® MONTHLY ❑ HOURLY tj MONTHLY DEPARTMENT Prosecutor BUDGET NUMBER A.001290251001 %:100 B. %:. A. %: B. %: WORKWEEK ❑ Standard ® ALT/1" Friday off: ❑ 207(k) ❑ Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $0 $ STIPEND (Detail in Comments Section) $0 $ OTHER (Detail in Comments Section) $0 $ SECTION 4: SIGNATURES (MUST BE SIGINOD4N BLUE INK) DEPARTMEW D/ ELECTE FIC AL / DATE BUDGET/P YRO DATE HUMAN DATE COMMISSION TE DATE COMM! O ` � � /PATE RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update Eval Date Eval Rating (IE—ID—S—AA—S) Initial 11� ".1 KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) LAST NAME Hill EMPLOYEE TYPE SECTION 1: EMPLOYEE DATA FIRST NAME EMPLOYEE # EFFECTIVE DATE Lorraine H0170 1-1-17 _ SECTION 2: TYPE OF ACTION EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ® FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE ❑ MERIT/ STEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ❑ TERMINATION (Provide Separation Info) ® OTHER (Describe Below) ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ RETIRED (R) ❑ CONDUCT (C) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ OTHER (0) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Increase per wage survey- effective 1-1-17; deferred to February payroll SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE SE Paralegal OCCUPATION CODE 2418 UNION CODE 40 PAY GRADE 218 STEP / POSITION 6 FLSA STATUS ® Non -Exempt ❑ Exempt ❑ Not Covered Non-Exempt`Exempt ❑ Not Covered ❑ Ineligible Ig PERS ❑ LEOFF ❑ PSERS ❑ Other DRS STATUS ❑ Ineligible ® PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 2-18-92 ADJ HIRE DATE 2-18-92 POSITION DATE 10-1-96 LAST RAISE DATE 1-1-16 1-1-17 BASE WAGE $3810. $4191 LONGEVITY $35. $ ` FTE ® 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $3810 $4191. PAYMENT METHOD ❑ HOURLY ® MONTHLY ❑ HOURLY MONTHLY DEPARTMENT Prosecutor BUDGET NUMBER A.001290251001 /:100 B. %: A. is B.: %: WORKWEEK ❑ Standard ® ALT/1" Friday off: ❑ 207(k) ❑ Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $0 $ STIPEND (Detail in Comments Section) $0 $ OTHER (Detail in Comments Section) $0 $ SECTION 4: SIGNATURES (MUST BE SIGNED IN BLUE INK) UEPARTM 0 / ELECT FC At DATE BUDGET/PA �y D �E HUMN_URCE DATE 11 COMM I E # i 0 TE CO #2 DATE COM AT RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update Eval Date EvalRating (IE—ID—S—AA—S) Initial cA �KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) LAST NAME Larrabee SECTION 1: EMPLOYEE DATA FIRST NAME EMPLOYEE # EFFECTIVE DATE I Lisa L1371 1-1-17 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ RETIRED (R) ❑ CONDUCT (C) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ OTHER (0) ❑ OTHER (0) ® FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE ❑ MERIT/ STEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ❑ TERMINATION (Provide Separation Info) ® OTHER (Describe Below) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Increase per wage scale- effective 1-1-17; deferred until February payroll SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE VW/SA Interviewer OCCUPATION CODE 2469 UNION CODE 40 PAY GRADE 269 STEP / POSITION 5 FLSA STATUS ® Non -Exempt ❑ Exempt ❑ Not Covered Non -Exempt [:]Exempt ❑Not Covered DRS STATUS ❑ Ineligible ® PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible 6 PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 1-2-01 ADJ HIRE DATE 1-2-01 POSITION DATE 4-4-05 LAST RAISE DATE 1-1-16 1-1-17 BASE WAGE $4011 $4412 LONGEVITY $0 $ FTE ® 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $4011 $4412 PAYMENT METHOD ❑ HOURLY ® MONTHLY ❑ HOURLY MONTHLY DEPARTMENT Prosecutor BUDGET NUMBER A.13051001 %:49.00 B. 130291151001 %:36.00 A. %: B. %: WORKWEEK ❑ Standard ® ALT/1" Friday off: ❑ 207(k) ❑ Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $0 $ STIPEND (Detail in Comments Section) $0 $ OTHER (Detail in Comments Section) $0 $ SECTI N 4: SIGNATURES (MUST BE SIGNED I INK) DEPART EAD / E CT OFfECIRL —~ _ DATE BUDGET/PAYROL j}„ DATE 77HU 4,R R DATE COMMISSION q DTE C 2 � ` DA TE L RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update EvalDate EvalRating(IE— ID—S—AA—S) Initial C4 ��•, KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) LAST NAME Schroeder SECTION 1: EMPLOYEE DATA FIRST NAME EMPLOYEE # EFFECTIVE DATE IJacob S2148 1-1-17 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION ❑ DISCHARGE (D) ❑ RESIGNATION (Q) ❑ RETIRED (R) ❑ LAID OFF (L) ❑ FAIL PROBATION (P) ❑ OTHER (0) REASON FOR SEPARATION ❑ PERFORMANCE (P) ❑ ATTENDANCE (A) ❑ CONDUCT (C) ❑ OTHER EMPLOYMENT (E) ❑ PERSONAL (L) ❑ OTHER (0) ® FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE ❑ MERIT/ STEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ❑ TERMINATION (Provide Separation Info) ® OTHER (Describe Below) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Increase per wage survey- effective 1-1-17; deferred until February payroll. SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Dat Report Enter new data JOB TITLE Software/Video Technician 5 OCCUPATION CODE -0- UNION CODE 40 PAY GRADE b0 A STEP / POSITION 5 FLSA STATUS ® Non -Exempt ❑ Exempt ❑ Not Covered Non -Exempt ❑ Exempt ❑ Not Covered DRS STATUS ❑ Ineligible ® PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible ® PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 4-6-09 ADJ HIRE DATE 8-4-09 POSITION DATE 12-1-16 LAST RAISE DATE 1-1-17 1-1-17 BASE WAGE $3311. $3477 LONGEVITY $0 $ FTE ® 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% ® 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $3311 $3477 PAYMENT METHOD ❑ HOURLY ® MONTHLY ❑ HOURLY Q MONTHLY DEPARTMENT Prosecutor BUDGET NUMBER A.001290151001 %:100 A. %: B. %: B. %: WORKWEEK ❑ Standard ® ALT/1" Friday off: ❑ 207(k) ❑ Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $0 $ STIPEND (Detail in Comments Section) $0 $ OTHER (Detail in Comments Section) $0 $ SECTION 4: SIGNATURES (MUST BE SIGNED IN BLUE INK) DEPAKTWU6 HEAD / ECT FFICIAL DATE BUDGETIP ROL D E DATE COMMISSIO11 D E CO R #2 DATE COMMISS s DA RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update Eval Date EvalRating(IE— ID—S—AA—S) Initial (Qommme-4-� KI'1" 1 ITAN C O U IN T Y YEKNUN IN EL AC;' MIN VUHM PAN SECTION 1: EMPLOYEE DATA LAST NAME FIRST NAME EMPLOYEE # EFFECTIVE DATE Eylar Marc I E1397 101/01/17 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE I EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ® FULL-TIME (1) ❑ NEW HIRE ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ PART-TIME (2) ❑ RE -HIRE ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ LIMITED PART-TIME (3) ❑ RETIRED (R) ❑ CONDUCT (C) ❑ TEMPORARY (4) ❑ POSITION CHANGE (Describe Below) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ CASUAL (5) ❑ BUDGET CHANGE (Describe Below) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ SEASONAL (6) ❑ LEAVE (List Type Below) ❑ OTHER (0) ❑ OTHER (0) ❑ PROJECT (7) rF.RMINATlON (Provide Separation Info) 7 ❑ Eligible For Rehire ❑ Ineligible For Rehire ❑ WORK STUDY (8) r THEE (17cicribe Below) ❑ VOLUNTEER (9) COMMENTS (include work schedule ifpositiu Placement on revised wage scale . $60 Smart Phone Allowance n is 'CSA. e)- �{- pay i C 111�'� � r�OftJCtt'�J rcl l l Provide Details of Separation Below WORKWEEK ® Standard ❑ Alternate ❑ 207(k) exception ❑ Standard ❑ Alternate ❑ 207(k) exception ALLOWANCE (Detail in Comments Sectign) $60 $60 STIPEND (Detail in Comments Section) $0 $ OTHER (Detail in Comments Section) $0 $ t A SECTION 4: SIGNATURES (MUST BE SIGNE BLUE INK) DEPART T11 I) /ELECTED I I � AN RESOURCE C _V&841e_ C(XfMtSSZA40Z#2 ©1/417 . 2 a v-7 DATE 21 k-611.1 RETURN FORM TO HUMAN I BUDGET/P!altol.f\ %DATE 2 f r1 COMMIS q DATE FOR Updated: 08/27/07 FOR HR USE: PAF Log NT Update Eval Date Eval Rating (IE — ID — S — AA — S) Initial SECTION 3: POSITION DATA Enter existing data from payroll system Enter new data to be input into payroll system JOB TITLE Assistant Coordinator OCCUPATION CODE 2463 UNION CODE 40 PAY GRADE 263 STEP / POSITION 7 FLSA STATUS ® Non -Exempt ❑ Exempt ❑ Not Covered [4 Non -Exempt ❑ Exempt ❑ Not Covered DRS STATUS ❑ Ineligible ® PERS ❑ LEOFF ❑ PSERS ❑ Ineligible 0PERS ❑ LEOFF ❑ PSERS HIRE DATE 04/01/01 ADJ HIRE DATE 09/01/01 POSITION DATE 09/01/01 LAST RAISE DATE 01/01/16 01/01/17 BASE WAGE $3701 $4366 LONGEVITY $0 $ FTE N 100% ❑ 80% ❑ 75% [160% ❑ 50% [4 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE (Calculate if FTE < 100%) $3701 $4366 PAYMENT METHOD ❑ HOURLY ® MONTHLY ❑ DAILY ❑ HOURLY W MONTHLY ❑ DAILY DEPARTMENT Noxious Weed BUDGET NUMBER A. 1230000000051001 A. % A. A. % B. B. % B. B. % WORKWEEK ® Standard ❑ Alternate ❑ 207(k) exception ❑ Standard ❑ Alternate ❑ 207(k) exception ALLOWANCE (Detail in Comments Sectign) $60 $60 STIPEND (Detail in Comments Section) $0 $ OTHER (Detail in Comments Section) $0 $ t A SECTION 4: SIGNATURES (MUST BE SIGNE BLUE INK) DEPART T11 I) /ELECTED I I � AN RESOURCE C _V&841e_ C(XfMtSSZA40Z#2 ©1/417 . 2 a v-7 DATE 21 k-611.1 RETURN FORM TO HUMAN I BUDGET/P!altol.f\ %DATE 2 f r1 COMMIS q DATE FOR Updated: 08/27/07 FOR HR USE: PAF Log NT Update Eval Date Eval Rating (IE — ID — S — AA — S) Initial C� ?�� K11 111AJ UVU1V IV lrhKN(JN1VhL AUTIUN rORM NAY SECTION 1: EMPLOYEE DATA LAST NAME FIRST NAME EMPLOYEE # EFFECTIVE DATE DAVIS I TODD I D1317 101/01/17 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION E FULL-TIME (1) ❑ NEW HIRE ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ PART-TIME (2) ❑ RE -HIRE ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ LIMITED PART-TIME (3) Sm . Ep ❑ RETIRED (R) ❑ CONDUCT (C) ❑ TEMPORARY (4) ❑ POSITION CHANGE (Describe Below) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ CASUAL (5) ❑ BUDGET CHANGE (Describe Below) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ SEASONAL (6) ❑ LEAVE (List Type Below) ❑ OTHER (0) ❑ OTHER (0) ❑ PROJECT (7) TEKM1NATION (Provide Separation Info) PAYMENT METHOD ❑ HOURLY E MONTHLY ❑ DAILY El WORK STUDY (8) uEk (Describe Below) ❑ Eligible For Rehire ❑ Ineligible For Rehire ❑ VOLUNTEER (9) {.'OMMi-N'rs (include work schedule if position is Placement on revised wage scale. $60 Smart Phone Allowance F41-jaNI F"y J - Provide Details of Senaration Below SECTION 3: POSITION DATA Enter exisling data from payroll system Enter new data to be input into eqvroii system JOB TITLE WEED BOARD COORDINATOR OCCUPATION CODE 1348 UNION CODE 30 PAY GRADE 148 STEP / POSITION 5 5 FLSA STATUS ❑ Non -Exempt E Exempt ❑ Not Covered ❑ Non -Exempt 10 Exempt ❑ Not Covered DRS STATUS EI -Ineligible E PERS ❑ LEOFF ❑ PSERS ❑ Ineligible [4 PERS ❑ LEOFF ❑ PSERS HIRE DATE 05/08/00 ADJ HIRE DATE 05/08/00 POSITION DATE 01/01/01 LAST RAISE DATE 01/01/16 01/01/17 BASE WAGE $4972 $5469 LONGEVITY $0 $ FTE E 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% 100% ❑ 80% E-175% ❑ 60% ❑ 50% FTE WAGE (Calculate if FTE < 100%) $4972 $5469 PAYMENT METHOD ❑ HOURLY E MONTHLY ❑ DAILY ❑ HOURLY MONTHLY ❑ DAILY DEPARTMENT NOXIOUS WEED BUDGET NUMBER A.1230000000051001 A.100% A. A. % B. B. % B. B. % WORKWEEK E Standard ❑ Alternate ❑ 207(k) exception ❑ Standard ❑ Alternate ❑ 207(k) exception ALLOWANCE (Detail in Comments Section) $60 $60 STIPEND (Detail in Comments Section) $0 $ OTHER (Detail in Comments Section) $0 $ SECTION 4: SIGNATURES (MUST BE SIGNED IN BLUE INK) DEPNt'I'MENT READ /ELECTED OFF C:IAL BATE. 11UDGU, 1PAYR DATE 559 Fi` MAN RFS IJR DATE COMM[SS lF DATE •R#2 DATE COMM. Fi f �. X13 ► l�- �� �- /.3-i � RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 08/27/07 FOR HR USE: PAF Log NT Update Eval Date Eval Rating (IE — ID — S — AA — S) Initial C� KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) LAST NAME Read _ SECTION 1: EMPLOYEE DATA FIRST NAME EMPLOYEE # EFFECTIVE DATE Robin R1881 01/01/2017 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION Q FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT(7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE ❑ MERIT / STEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ❑ TERMINATION (Provide Separation Info) OTHER (Describe Below) ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ RETIRED (R) ❑ CONDUCT (C) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ OTHER (0) ❑ OTHER (0) ❑ Eligible For Rehire g' [:1 Ineligible For Rehire Provide Details of Separation Below COMMENTS: Increase per wage survey - payment effective 1/1/17; deferred until February payroll, SECTION 3: POSITION DATA Enterexisting dotalrom CAMAS Wage Data Report Enter new data JOB TITLE PUBLIC HEALTH ADMINISTRATOR OCCUPATION CODE 1306 UNION CODE 30 PAY GRADE 106 STEP / POSITION 5 FLSA STATUS ❑ Non -Exempt Q Exempt ❑ Not Covered ❑ Non -Exempt Q Exempt ❑ Not Covered DRS STATUS ❑ Ineligible ❑' PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible Q PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 8/2/2006 ADJ HIRE DATE 8/2/2006 POSITION DATE 9/1/2013 LAST RAISE DATE 1/1/2016 BASE WAGE $6,004.00 $IbAbl.00 LONGEVITY $ 0.00 $ FTE p 100% [:180% ❑ 75% ❑ 60% [150% 0 100% ❑ 80% ❑ 75% ❑ 60% [:150% FTE WAGE $ 6,004.00 $ 6,461.00 PAYMENT METHOD ❑ HOURLY ❑' MONTHLY ❑ HOURLY [j] MONTHLY DEPARTMENT PUBLIC HEALTH BUDGET NUMBER A. 116 000000000061151001 %: 100.00 B. %: A. %: B. %: WORKWEEK ❑' Standard ❑ ALT/1" Friday off: F -1207(k) ❑� Standard ❑ ALT/I" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $ 0.00 $ 0.00 STIPEND (Detail in Comments Section) $ 0.00 $ 0.00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES (MUST BE SIGNED IN BLUE INK) DEPARTMENT HEAD/ ELECTED OFFICIAL DATE BUDGET/PAYRp DATE - 2I/f(// ( HUMAN RESOURCE 1 DATE I ) COMMISSIO DATE 112 j !�! ) DATE �6 G_ COMMl55! r �— D4�' _1 2:4 RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update Eval Date EvalRating(IE- ID - S - AA - S) Initial `: KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) LAST NAME Murray SECTION 1: EMPLOYEE DATA FIRST NAME EMPLOYEE # EFFECTIVE DATE Lisa M2490 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ❑r FULL-TIME (1) ❑ NEW HIRE ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ PART-TIME (2) ❑ RE -HIRE ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ LIMITED PART-TIME (3) RETIRED (R) ❑ CONDUCT (C) ❑ TEMPORARY (4) ❑ POSITION CHANGE (Describe Below) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ CASUAL (5) ❑ BUDGET CHANGE (Describe Below) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ SEASONAL (6) ❑ LEAVE (List Type Below) ❑ OTHER (0) ❑ OTHER (0) ❑ PROJECT (7) ❑RMINATION (Provide Separation Info) ❑ WORK STUDY (8) kerGTHER (Describe Below) ❑ Eligible For Rehire ❑ Ineligible For Rehire ❑ VOLUNTEER (9) Provide Details of Separation Below COMMENTS: Increase per wage survey -payment effective 1/1/17; deferred until February payroll. SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE ADMINISTRATIVE ASSISTANT III OCCUPATION CODE 3376 UNION CODE 30 PAY GRADE 376 STEP / POSITION 5 FLSA STATUS ❑ Non -Exempt ❑� Exempt ❑ Not Covered ❑ Non -Exempt ❑� Exempt p [I Not Covered DRS STATUS ❑ Ineligible [j] PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible Q PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 1/13/2014 ADJ HIRE DATE 1/13/2014 POSITION DATE 1/13/2014 LAST RAISE DATE 1/1/2016 01/01/2017 BASE WAGE $ 3,413.00 $ 3,656.00 LONGEVITY $ 0.00 $ FTE ❑' 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% ❑� 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $ 3,413.00 $ 3,656.00 PAYMENT METHOD ❑ HOURLY ❑E MONTHLY ❑ HOURLY Q MONTHLY DEPARTMENT TREASURER BUDGET NUMBER A. 001 000000000003151001 %: 100.00 B. 96: A. %: B. %: WORKWEEK 2 Standard ❑ ALTA 't Friday off: ❑ 207(k) Standard ❑ ALT/1't Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to '0". ALLOWANCE (Detail in Comments Section) $ 0.00 $ 0.00 STIPEND (Detail in Comments Section) $ 0.00 $ 0,00 OTHER (Detail in Comm* ?s Section) $ 0.00 $ 0.00 11 SECTION 4: SIGNATURES (MUST BE SIGNED IN BLUE INK) DEP ME HEAD/ E CTED OFFI L.BUDG r i .; ATE " I P OLL DAT l tr lj �1.. AN ES URGE C 5 ER DATE I `DATECOMMI l L I COMMI {} E E r \ T_ RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update Eval Date Eval Rating (IE—ID—S—AA—S) Initial c� KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) Updated: 04/08/11 FOR HRUSE7 NT Update Eval Date EvalRating(IE— ID — S —AA — S) Initial SECTION 1: EMPLOYEE DATA LAST NAME Bowen FIRST NAME Karen EMPLOYEE # EFFECTIVE DATE B2027 441/2017 SECTION 2: TYPE OF ACTION EMP OYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE ❑ MERIT/ STEP ❑ POSITION CHANGE (Describe Below) 4;3-0l (X*T-eRANGE (Describe Below) ❑ LEAVE (List Type Below) TERMINATION (Provide Separation Info) THER (Describe Below) ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ RETIRED (R) ❑ CONDUCT (C) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ OTHER (0) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Details of Separation Below Provide ^� n COMMENTS: �'�l/V'-Ll�c�/f(1%i/�Q,y C����v�✓�,%7n �"V,��I�l".."�r/wnnoii IV 1�✓�p���/11"'� "SEECrIION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE ADMINISTRATIVE ASSISTANT III OCCUPATION CODE 3376 UNION CODE 30 PAY GRADE 376 STEP / POSITION 5 FLSA STATUS ❑ Non -Exempt ❑� Exempt ❑ Not Covered ❑ Non -Exempt Exempt ❑ Not Covered DRS STATUS ❑ Ineligible El PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible Q PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 11/26/2007 ADJ HIRE DATE 11/26/2007 POSITION DATE 3/9/2015 LAST RAISE DATE 1/1/2016 4 BASE WAGE $ 3,505.00 $ 3,680.00 LONGEVITY $ 0.00 $ FTE 0 l00% ❑ 80% ❑ 75% ❑ 60% ❑ 50% 2 100/ ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $ 3,505.00 $ 3,680.00 PAYMENT METHOD ❑ HOURLY E MONTHLY ❑ HOURLY [j] MONTHLY DEPARTMENT CLERK B U DG ET N U M B E R A.001 000000000001551001 %: 100.00 B. %: A. %: B. %: WORKWEEK E] Standard ❑ ALT/1" Friday off: ❑ 207(k) El Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $ 0.00 $ 0.00 STIPEND (Detail in Comments Section) $ 0.00 $ 0.00 OTHER (Detail in Comments Section) $ 0.00 $ 0,00 SECTION 4: SIGNATURES (MUST BE SIGNED IN BLUE INK) DEP NT HE / ELECTED 0 FICIAL DAT �/�I l BUDG PA LL DATV H ARAN RE URGE Tr-7COMMISSI DATE C ER DATE COMMISS Df/E_ RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HRUSE7 NT Update Eval Date EvalRating(IE— ID — S —AA — S) Initial KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) Updated: 04/08/11 FOR HR USE: NT Update Eval Date Eval Rating (IE—ID—S—AA—S) Initial SECTION 1: EMPLOYEE DATA LAST NAME Seibert FIRST NAME Heather EMPLOYEE # S2486 EFFECTIVE DATE 01/01/2017 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ❑✓ FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE ❑ MERIT/ STEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ❑ TERMINATION (Provide Separation Info) ❑� OTHER (Describe Below) ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ RETIRED (R) ❑ CONDUCT (C) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ OTHER (0) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Position's scale adjusted st� pAer BOCC and Sheriff, effective 1/1/17. SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE CHIEF FINANCIAL MANAGER - KCSO OCCUPATION CODE 1312 UNION CODE 30 PAY GRADE 112 STEP / POSITION 5 FLSA STATUS ❑ Non -Exempt Il Exempt ❑ Not Covered ❑ Non -Exempt El Exempt ❑ Not Covered DRS STATUS ❑ Ineligible [j] PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible El PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 1/2/2014 ADJ HIRE DATE 1/2/2014 POSITION DATE 8/24/2015 LAST RAISE DATE 1/1/2016 4 BASE WAGE $3,948.00 $'4,414.00 LONGEVITY $ 0.00 $ FTE ❑� 100% ❑ 80% [:175% ❑60% [:150% Q 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $3,948.00 $4,414.00 PAYMENT METHOD ❑ HOURLY ❑� MONTHLY ❑ HOURLY ❑� MONTHLY DEPARTMENT SHERIFF BUDGET NUMBER A. 001 000000000300151001 %: 100.00 B. %: A. %: B. %: WORKWEEK E] Standard ❑ ALT/1" Friday off: ❑ 207(k) E] Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "O". ALLOWANCE (Detail in Comments Section) $ woo $ 0,00 STIPEND (Detail in Comments Section) $ 0,00 $ 0,00 $ 0.00 $ 0,00 OTHER (Detail in Comments Section) SECTION 4: SIGNATURES (MUST BE SIGNES11N BLUE INK) DEPARTMENT HEADfri ECTED O CI DATE BUDGET/PAY OLL AfE HUMAN RESOURCE DATE COMMISSi DAT C I N A71 COMM _ATE RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update Eval Date Eval Rating (IE—ID—S—AA—S) Initial L� KITTITAS COUNTY PERSONNEL ACTION FORM (P I� SECTION 1: EMPLOYEE DATA LAST NAME FIRST NAME EMPLOYEE # EFFECTIVE DATE Gigstead Patrick G0245 SECTION 2: TYPE OF ACTION EMPLOYEE TYPES EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ❑� FULL-TIME (1) ❑ NEW HIRE ❑ DISCHARGE (D) ❑PERFORMANCE (P) ❑ PART-TIME (2) ❑ RE -HIRE ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ LIMITED PART-TIME (3) ❑ MERIT/ STEP ❑ RETIRED (R) ❑ CONDUCT (C) ❑ TEMPORARY (4) ❑ POSITION CHANGE (Describe Below) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ CASUAL (5) ❑ BUDGET CHANGE (Describe Below) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ SEASONAL (6) ❑ LEAVE (List Type Below) ❑ OTHER (0) ❑ OTHER (0) ❑ PROJECT (7) ❑ TERMINATION (Provide Separation Info) ❑ WORK STUDY (8) OTHER (Describe Below) ❑ Eligible For Rehire ❑ Inetiglble For Rehire ❑ VOLUNTEER (9) Provide Details of Separation Below COMMENTS Increase per wage survey - payment effective 1/1/17; deferred until February payroll. New Min: $4453; New Mid: $5166; New Max: $5993 SECTION 3: POSITION DATA EnterexEsting data from CAMAS Wage Data Report Enter new data JOB TITLE CHIEF PROBATION OFFICER OCCUPATION CODE 2311 UNION CODE 30 PAY GRADE 211 STEP / POSITION 5 FLSA STATUS ❑ Non -Exempt ❑' Exempt ❑ Not Covered ❑ Non -Exempt ❑� Exempt ❑ Not Covered DRS STATUS ❑ Ineligible ❑ PERS ❑ LEOFF ❑� PSERS ❑ Other ❑ Ineligible ❑ PERS ❑ LEOFF ❑' PSERS ❑ Other HIRE DATE 7/10/2006 ADJ HIRE DATE 7/10/2006 POSITION DATE 9/2/2015 LAST RAISE DATE 1/1/2015 BASE WAGE $ 5,301.00 $ 5, 31.00 LONGEVITY $ 0.00 $ FTE ❑� 100% ❑ 80% [175% ❑60% [:150% Q 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $ 5,301.00 $ 5,831.00 PAYMENT METHOD ❑ HOURLY Q MONTHLY ❑ HOURLY ❑� MONTHLY DEPARTMENT MISDEMEANANT PROBATION BUDGET NUMBER A. 127 000000000000051001 %: 100.00 B. %; A. %: B. %: WORKWEEK ❑� Standard ❑ ALT/1" Friday off: ❑ 207(k) 0 Standard ❑ ALTA" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to '0". ALLOWANCE (Detail in Comments Section) $ 0.00 $.0.00 STIPEND (Detail in Comments Section) $ 0.00 $ 0.00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES [MUST BE SIGNED IN BLUE INK). DE ATMENT H All / E CTED0 CIAL DATE f -30 -1 BUAGETjP p DAT �7]r�I pyl RESOUg DATE COMMiSSIO CAT CO DATE 171 I COMMISSIO � /'3 --/ 7 RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update Eval Date EvalRating(IE—ID—S—AA—S) Initial KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) LAST NAME Stafford SECTION 1: EMPLOYEE DATA FIRST NAME EMPLOYEE # EFFECTIVE DATE Michael S1503 01/01/2017 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION Q FULL-TIME (1) �] PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE ❑ MERIT/ STEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ❑ TERMINATION (Provide Separation Info) ❑✓ OTHER (Describe Below) ❑ DISCHARGE (D) ❑ RESIGNATION (Q) ❑ RETIRED (R) ❑ LAID OFF (L) ❑ FAIL PROBATION (P) ❑ OTHER (0) ❑ PERFORMANCE (P) ❑ ATTENDANCE (A) ❑ CONDUCT (C) ❑ OTHER EMPLOYMENT (E) ❑ PERSONAL (L) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Increase per wage survey -payment effective 1/1/2017; deferred until February payroll. SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE JUVENILE COURT ADMINISTRATOR OCCUPATION CODE 2327 UNION CODE 30 PAY GRADE 227 STEP / POSITION 5 FLSA STATUS ❑ Non -Exempt I] Exempt ❑ Not Covered ❑ Non -Exempt (] Exempt ❑ Not Covered DRS STATUS ❑ Ineligible ❑ PERS ❑ LEOFF [j] PSERS ❑ Other ❑ Ineligible ❑ PERS ❑ LEOFF [j] PSERS ❑ Other HIRE DATE 1/27/2003 ADJ HIRE DATE 1/27/2003 POSITION DATE 9/2/2015 LAST RAISE DATE 1/1/2016 r BASE WAGE $ 5,430.00 $ 5,973.00 LONGEVITY $ 0.00 $ FTE ❑� 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% Q 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $ 5,430.00 $ 5,973.00 PAYMENT METHOD ❑ HOURLY ❑� MONTHLY ❑ HOURLY Q MONTHLY DEPARTMENT JUVENILE PROBATION BUDGET NUMBER A. 001 000000000220151001 %: 100.00 B. %: A. %: B. %: WORKWEEK 0 Standard ❑ ALT/1" Friday off: ❑ 207(k) I 0 Standard ❑ ALT/1" Friday off: _ ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to '0". ALLOWANCE (Detail in Comments Section) $ 0.00 $ 0.00 STIPEND (Detail in Comments Section) $ 0,00 $ 0.00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES (MUST BE SIGNED IN BLUE INK) A T D / ELfETED OFFICIAL DATE 17 BUDGET/PAY OCL] �'TE HU AN RESOURCE I7 -1-77 - COMMIS DA A; CO ER DATE COMM{ s TE RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update Eval Date Eval Rating (IE—ID—S—AA—S) Initial Q_� KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) _ SECTION 1: EMPLOYEE DATA LAST NAME Sorensen FIRST NAME Julie EMPLOYEE # S1310 EFFECTIVE DATE 01/01/2017 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE -9-{v IRMTI-Smr, ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) aTERMINATION (Provide Separation Info) HER (Describe Below) ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ RETIRED (R) ❑ CONDUCT (C) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ OTHER (0) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS -. Wage rate change consistent with wage rate survey and revised position description. _ �J�� v D om, SECTION 3: POSITION DATA _ Enter existing datafrom CAMAS Wage Data Report Enter new data JOB TITLE PROGRAM ASSISTANT 4-H Program Coordinator OCCUPATION CODE 2448 UNION CODE 40 PAY GRADE 248 STEP / POSITION 6 FLSA STATUS Non -Exempt ❑ Exempt ❑ Not Covered Il Non -Exempt ❑ Exempt ❑ Not Covered DRS STATUS ❑ Ineligible 0 PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible 0 PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 4/11/2000 ADJ HIRE DATE 12/1/2003 POSITION DATE 4/11/2000 LAST RAISE DATE 1/1/2016 till _' BASE WAGE $ 2,999.00 0,'149.00 LONGEVITY $ 0.00 $ FTE ❑p 100% [:180% ❑ 75% ❑ 60% [:150% ❑p 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $ 2,999.00 $ 3,149.00 PAYMENT METHOD ❑ HOURLY Il MONTHLY ❑ HOURLY 0 MONTHLY DEPARTMENT WSU EXTENSION BUDGET NUMBER A. 001 000000000001851001 %: 100.00 B. %: A. %: B. %: WORKWEEK Standard ❑ ALT/1" Friday off: ❑ 207(k) ❑' Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $ 0.00 $ 0.00 STIPEND (Detail in Comments Section) 1$0.00 $ 0.00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES (MUST BE SIGNED IN BLUE INK) Ej+ir HF�AD / E ED oFFICK D E BUDGET/PAYROLL f7 DATE /d HU AN ESOURCE DA COMMI C' £R #2 DATE CO DATE RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update Eval Date Eval Rating (IE — ID — S — AA — S) Initial N KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) LAST NAME Haberman _ SECTION 1: EMPLOYEE DATA FIRST NAME EMPLOYEE # EFFECTIVE DATE Laurie H009E 01/01/2017 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ❑✓ FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE ❑ MERIT/ STEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ❑ TERMINATION (Provide Separation Info) ❑✓ OTHER (Describe Below) ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ RETIRED (R) ❑ CONDUCT (C) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ OTHER (0) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Increase per wage survey- payment effective 1/1/2017; deferred until February payroll. SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE DIVERSION COORDINATOR OCCUPATION CODE 2405 UNION CODE 40 PAY GRADE 205 STEP / POSITION 5 FLSA STATUS (] Non -Exempt ❑ Exempt ❑ Not Covered 0 Non -Exempt ❑ Exempt ❑ Not Covered DRS STATUS ❑ Ineligible Il PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible Il PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 6/24/1998 ADJ HIRE DATE 12/7/1998 POSITION DATE 7/5/2000 LAST RAISE DATE 1/1/2016 BASE WAGE $ 3,902.00 $ 4, 92.00 LONGEVITY $ 0.00 $ FTE ❑� 100% C]80% [:]75% [:]60% ❑ 50% ❑� 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $3,902.00 $4,292.00 PAYMENT METHOD ❑ HOURLY I] MONTHLY ❑ HOURLY 0 MONTHLY DEPARTMENT JUVENILE PROBATION BUDGET NUMBER A. 001 000000000220251001 %: 56.25 B. 001000000220222151001 %:43.75 A. %: B. %: WORKWEEK E Standard ❑ ALT/1" Friday off: ❑ 207(k) Il Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $ 0.00 $ 0.00 STIPEND (Detail in Comments Section) $ 0.00 $ 0.00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SE ION 4: SIGNATURES MUST BE SIGNED IN BLUE INK DEPA TMEN 8i EDO icl HU R OLIRCEDATE DAT 111 BUDGET AYRO DAT,, 7I/ 3 / COMM10 DA 2d] cc DATE COMMI TE (7 / RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update Eva[Date EvalRating(IE— ID — S —AA—S) Initial KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) Updated: 04/08/11 FOR HR USE: NT Update EvalDate EvalRating(IE—ID—S—AA—S) Initial SECTION 1: EMPLOYEE DATA LAST NAME Lawrence FIRST NAME EMPLOYEE # Lisa B1041 EFFECTIVE DATE 1/01/2017 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE ❑ MERIT / STEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) TERMINATION (Provide Separation Info) THE R (Describe Below) ❑ DISCHARGE (D) ❑ RESIGNATION (Q) ❑ RETIRED (R) ❑ LAID OFF (L) ❑ FAIL PROBATION (P) ❑ OTHER (0) ❑ PERFORMANCE (P) ❑ ATTENDANCE (A) ❑ CONDUCT (C) ❑ OTHER EMPLOYMENT (E) ❑ PERSONAL (L) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Increase per wage survey -payment effective 1/1/17; deferred until February payroll. ,( SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE ASSISTANT DIRECTOR OCCUPATION CODE 3387 UNION CODE 30 PAY GRADE 387 STEP / POSITION 6 FLSA STATUS ❑ Non -Exempt E] Exempt ❑ Not Covered ❑ Non -Exempt Q Exempt ❑ Not Covered DRS STATUS ❑ Ineligible O PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible Q PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 5/6/1997 ADJ HIRE DATE 9/9/1997 POSITION DATE 11/6/2006 LAST RAISE DATE 1/1 /2016 tit I I _- BASE WAGE $ 5,421.00 $ 5,791.00 LONGEVITY $ 0.00 $ FTE ❑� 100% ❑ 80% [:175% ❑ 60% ❑ 50% ❑ 100% ❑ 80% ❑ 75% ❑ 60% [150% FTE WAGE $ 5,421.00 $ 5,791.00 PAYMENT METHOD ❑ HOURLY Q MONTHLY ❑ HOURLY Q MONTHLY DEPARTMENT SOLID WASTE BUDGET NUMBER A. 401 000000000400151001 %: 100.00 A. %: B. %: B. %: WORKWEEK E Standard ❑ ALT/I" Friday off: ❑ 207(k) E] Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $ 25.00 $ 25.00 STIPEND (Detail in Comments Section) $1,000.00 $ 1,000.00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES MUST BE SIGNED IN BLUE INK) MPA NT HEAD/ ELECTED OFF1CtAL— D BUDGETJP DATE ��_ �i3li HUMAN RESOURCE bAj COMMISSi D I C M ! []ATE CO T RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update EvalDate EvalRating(IE—ID—S—AA—S) Initial r�KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) Updated: 04/08/11 FOR HR USE: NT Update Eval Date Eval Rating (IE—ID—S—AA—S) Initial SECTION 1: EMPLOYEE DATA LAST NAME Van De Venter FIRST NAME EMPLOYEE # EFFECTIVE DATE Clinton V2511 1/01/2017 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ULL-TI ME (1) PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE ❑ MERIT/ STEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ERM''INATION (Provide Separation Info) THER (Describe Below) ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ RETIRED (R) ❑ CONDUCT (C) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ OTHER (0) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire 1 Provide Details of Separation Below COMMENTS: Increase per wage survey -payment effective 1/1/17; deferred until February payroll. i 1 0 A lel l ' j SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE HHW SUPERVISOR OCCUPATION CODE 2321 UNION CODE 30 PAY GRADE 221 STEP / POSITION 5 FLSA STATUS ❑ Non -Exempt Q Exempt [:]Not Covered Non -Exempt [j] Exempt ❑ Not Covered DRS STATUS ❑ Ineligible [j] PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible I] PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 3/25/2014 ADJ HIRE DATE 3/25/2014 POSITION DATE 10/12/2015 LAST RAISE DATE 1/1/2016 l BASE WAGE $4,693.00 $4,928.00 LONGEVITY $ 0.00 $ FTE ❑p 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% ❑Q 100% [:180% ❑ 75% ❑ 60%E150% FTE WAGE $ 4,693.00 $ 4,928.00 PAYMENT METHOD ❑ HOURLY Q MONTHLY ❑ HOURLY ❑� MONTHLY DEPARTMENT SOLID WASTE BUDGET NUMBER A. 401 000000000040951001 %: 60.00 B. 401000000004150151001 %:40.00 A. %: B. %: WORKWEEK Il Standard ❑ ALT/1" Friday off: ❑ 207(k) E Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to '0'. ALLOWANCE (Detail in Comments Section) $ 25.00 $ 25.00 STIPEND (Detail in Comments Section) $ 0,00 $ 0.00 OTH ER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES (MUST BE SIGNS I.N BLUE INK) DEPARTM EAD'/ ELECT OFFI IAL_ PATE Lail: BUDGET/P OLL h O TE -1311 _.4� HUMA RESOURCECOMMTS5[DW C I E 2►13E1 COMMI ATE � �` �-�3 RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update Eval Date Eval Rating (IE—ID—S—AA—S) Initial [ KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) LAST NAME Highland SECTION 1: EMPLOYEE DATA FIRST NAME EMPLOYEE # EFFECTIVE DATE Carole H2749 1-114.7 ill -711-7 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ® FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE ❑ MERIT/ STEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ❑ TERMINATION (Provide Separation Info) ® OTHER (Describe Below) ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ RESIGNATION (C1) ❑ ATTENDANCE (A) ❑ RETIRED (R) ❑ CONDUCT (C) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ OTHER (0) ❑ OTHER (0) ❑ Eligible For Rehire 0Ineligible For Rehire Provide Details of Separation Below COMMENTS: Increase per wage survey- effective I-�7; deferred until February payroll %101x7 SECTION 3: POSITION DATA Enter existing datafrom CAMAS Wage Data Report Enter new data JOB TITLE DPA III OCCUPATION CODE 2317 UNION CODE 30 PAY GRADE 217 STEP / POSITION 5 ❑ Non -Exempt ® Exempt ❑ Not Covered FLSA STATUS © Non -Exempt f5� Exempt ❑ Not Covered DRS STATUS ❑ Ineligible ® PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible [N PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 1-17-17 ADJ HIRE DATE 1-17-17 POSITION DATE 1-17-17 LAST RAISE DATE 1-17-17 BASE WAGE $6585 $6756 LONGEVITY $0 $ FTE 0100%E] 80% ❑ 75% ❑ 60% ❑ 50% © 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $6585 $6756 PAYMENT METHOD ❑ HOURLY ® MONTHLY ❑ HOURLY ® MONTHLY DEPARTMENT Prosecutor BUDGET NUMBER A.001290151001 /:100 B. %; A. r: B. %: WORKWEEK ® Standard ❑ ALT/1" Friday off: ❑ 207(k) ❑ Standard ❑ ALT/I" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $25 $ ` STIPEND (Detail in Comments Section) $0 $ OTHER (Detail in Comments Section) $0 $ SECTI 4: SIGNATURES (MUST BE SIGNED IN BLUE INK) DEPARTME q / £L£ E FACIAL DATE BUD R ROLL DATE DATE COMMi TO DA E CO H2 t ATE -1�t I' COMMlSS E 9-113 RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update EvalDate EvalRating(IE— ID—S—AA—S) Initial KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) LAST NAME Sprague SECTION 1: EMPLOYEE DATA FIRST NAME EMPLOYEE # EFFECTIVE DATE Mark � S2646 1-1-17 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ® FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE ❑ MERIT/ STEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ❑ TERMINATION (Provide Separation Info) ® OTHER (Describe Below) ❑ DISCHARGE (D) ❑ RESIGNATION (Q) ❑ RETIRED (R) ❑ LAID OFF (L) ❑ FAIL PROBATION (P) ❑ OTHER (0) ❑ PERFORMANCE (P) ❑ ATTENDANCE (A) ❑ CONDUCT (C) ❑ OTHER EMPLOYMENT (E) ❑ PERSONAL (L) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Increase per wage survey- effective 1-1-17; deferred until February payroll a4nce2EE;, SECTION 3: POSITION DATA Enter existing datafrom CAMAS Wage Data Report Enter new data JOB TITLE DPA I OCCUPATION CODE 2314 UNION CODE 30 PAY GRADE 214 STEP / POSITION 5 FLSA STATUS ❑ Non -Exempt ® Exempt ❑ Not Covered ❑ Non -Exempt 13 Exempt ❑ Not Covered DRS STATUS ❑ Ineligible ® PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible ® PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 9-8-15 ADJ HIRE DATE 9-8-15 POSITION DATE 9-8-15 LAST RAISE DATE 1-1-16 1-1-17 BASE WAGE $4135 $4552 LONGEVITY $0 $ FTE ® 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% 5j100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $4135 $4552 PAYMENT METHOD ❑ HOURLY ® MONTHLY ❑ HOURLY W MONTHLY DEPARTMENT Prosecutor BUDGET NUMBER A.001290151001 %:100 B. %: A. %: B. %: WORKWEEK ® Standard ❑ ALT/1" Friday off: ❑ 207(k) ❑ Standard ❑ ALT/I" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $25 $ 'w [ STIPEND (Detail in Comments Section) $0 $ OTHER (Detail in Comments Section) $0 $ y SECTION 4: SIGNATURES (MUST BE SIGNED IN BLUE INK) DEPART E HEAD/ FICIAL DATE BUDGET AY LL D TE HU R OU A/YIA�,4� DATE COMMIS D 2 i//7 CO n DATE COMMISSI + j i 12 i ` l RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update EvalDate EvalRating(IE— ID—S—AA—S) Initial C-� KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) I LAST NAME Sander SECTION 1: EMPLOYEE DATA FIRST NAME EMPLOYEE # Paul S1664 SECTION 2: TYPE OF ACTION EFFECTIVE DATE 1-1-17 EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ® FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE ❑ MERIT/ STEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ❑ TERMINATION (Provide Separation Info) ® OTHER (Describe Below) ❑ DISCHARGE (D) ❑ RESIGNATION (Q) ❑ RETIRED (R) ❑ LAID OFF (L) ❑ FAIL PROBATION (P) ❑ OTHER (0) ❑ PERFORMANCE (P) ❑ ATTENDANCE (A) ❑ CONDUCT (C) ❑ OTHER EMPLOYMENT (E) ❑ PERSONAL (L) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Increase per wage survey- effective 1-1-7; deferred until February payroll SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE DPA III OCCUPATION CODE 2317 UNION CODE 30 PAY GRADE 217 STEP / POSITION 6 FLSA STATUS ❑ Non -Exempt ® Exempt [:]Not Covered ❑ Non -Exempt ® Exempt ❑ Not Covered DRS STATUS ❑ Ineligible ® PERS ❑ LEOFF ❑ PSERS ❑ Other 11-1-04 ❑ Ineligible ® PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE ADJ HIRE DATE 11-1-04 POSITION DATE 7-1-07 LAST RAISE DATE 1-1-16 1-1-17 BASE WAGE $6880 $7153.. LONGEVITY $0 $ FTE 0100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% 10.100o ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $6880 $7153 PAYMENT METHOD ❑ HOURLY ® MONTHLY ❑ HOURLY MONTHLY DEPARTMENT BUDGET NUMBER Prosecutor A. 12029015 1001 %:100 B. %: A. B. %: %: WORKWEEK ® Standard ❑ ALT/I" Friday off: ❑ 207(k) ❑ Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0", ALLOWANCE (Detail in Comments Section) $25 $ STIPEND (Detail in Comments Section) $0 $ OTHER (Detail in Comments Section) $0 $ SECTION 4: SIGNATURES (MUST BE S ED IN BLUE INK) DEPART 6 FrEAD / E E P ICIAL DATE BUi]G JPAY L DTE HUM so n DATE G coMMls to o E CD N �DATE 2. COMMISSI 3 f6A RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update EvalDate EvalRating(IE— ID—S—AA—S) Initial C� KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) Updated: 04/08/11 FOR HR USE: NT Update Eval Date EvalRating (IE—ID—S—AA—S) Initial SECTION 1: EMPLOYEE DATA LAST NAME Mitchell FIRST NAME J Douglas EMPLOYEE # M 13 04 EFFECTIVE DATE 1-1-17 SECTION 2: TYPE OF ACTION TYPE OF SEPARATION REASON FOR SEPARATION EMPLOYEE TYPE ® FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) EMPLOYEE ACTION ❑ NEW HIRE ❑ RE -HIRE ❑ MERIT/ STEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ❑ TERMINATION (Provide Separation Info) ® OTHER (Describe Below) ❑ DISCHARGE (D) ❑ RESIGNATION (Q) ❑ RETIRED (R) ❑ LAID OFF (L) ❑ FAIL PROBATION (P) ❑ OTHER (0) ❑ PERFORMANCE (P) ❑ ATTENDANCE (A) ❑ CONDUCT (C) ❑ OTHER EMPLOYMENT (E) ❑ PERSONAL (L) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Increase per wage survey- effective 1-1-17; deferred until February payroll SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE DPA III OCCUPATION CODE 2317 UNION CODE 30 PAY GRADE 217 STEP / POSITION 5 FLSA STATUS ❑ Non -Exempt ® Exempt ❑ Not Covered ❑ Non -Exempt Q Exempt ❑ Not Covered DRS STATUS ❑ Ineligible ® PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible qPERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 9-15-14 ADJ HIRE DATE 9-15-14 POSITION DATE 9-15-14 1-1-16 LAST RAISE DATE 1-1-17 BASE WAGE $6585 $6756 LONGEVITY $0 $ FTE 0100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% 100%080%E] 75% ❑ 60% ❑ 50% FTE WAGE $6585 $6756 PAYMENT METHOD ❑ HOURLY ® MONTHLY ❑ HOURLY MONTHLY DEPARTMENT Prosecutor BUDGET NUMBER A.001290351001 %:100 B. %: A. %: B. %: WORKWEEK ® Standard ❑ ALT/I" Friday off: ❑ 207(k) ❑ Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to 11011. ALLOWANCE (Detail in Comments Section) $0 $ STIPEND (Detail in Comments Section) $0 $ OTHER (Detail in Comments Section) $0 $ SECTION 4: SIGNATURES (MUST BE SIGNED MBLUE INK) DEPARTME D/ELECT Fi AL - DATE BUDGET/PAY LL qATE 311 HU,AkftabURCELf DATE COMM R 0 jh, co N DATE CSM RETURN FORM TO HUMAN RESOURCES FOR DISTRIOLTrION Updated: 04/08/11 FOR HR USE: NT Update Eval Date EvalRating (IE—ID—S—AA—S) Initial ' KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) Updated: 04/08/11 FOR HR USE: NT Update Eval Date EvalRating(IE— ID—S—AA—S) Initial SECTION 1: EMPLOYEE DATA LAST NAME Horner FIRST NAME EMPLOYEE # Chris H2474 SECTION 2: TYPE OF ACTION EFFECTIVE DATE 1-1-17 EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ® FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE ❑ MERIT/ STEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ❑ TERMINATION (Provide Separation Info) ® OTHER (Describe Below) ❑ DISCHARGE (D) D PERFORMANCE (P) ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ RETIRED (R) ❑ CONDUCT (C) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ OTHER (0) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Increase per wage survey- effective 1-1-17; deferred to February payroll SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE DPA II OCCUPATION CODE 2315 UNION CODE 30 PAY GRADE 215 STEP / POSITION 5 FLSA STATUS ❑ Non -Exempt ® Exempt []Not Covered ❑ Non -Exempt Q Exempt ❑ Not Covered DRS STATUS ❑ Ineligible ® PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 9-3-13 ADJ HIRE DATE 9-3-13 POSITION DATE 9-3-13 LAST RAISE DATE 1-1-16 1-1-17 BASE WAGE $5115. $6168. LONGEVITY $0 $ FTE ® 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% 10 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $5115 $6168. PAYMENT METHOD ❑ HOURLY ® MONTHLY ❑ HOURLY 14 MONTHLY DEPARTMENT Prosecutor BUDGET NUMBER A.00129O351OO1 %:100 B. %: A. B. %: %: WORKWEEK ® Standard ❑ ALT/1" Friday off: ❑ 207(k) ❑ Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $0 $ STIPEND (Detail in Comments Section) $0 $ OTHER (Detail in Comments Section) $0 $ SECTION 4: SIGNATURES (MUST BE SIGNED IN BLUE INK) DEPARTME 0 / ELECTEDlffF.0 DATE 7r BUDGET/PA OL L /_ ATE �!( IJ L. HU E �' RTE COMM slulpify CO 0 DAT y� f iE CO DATE 2 RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update Eval Date EvalRating(IE— ID—S—AA—S) Initial C� KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) LAST NAME Caulkins SECTION 1: EMPLOYEE DATA FIRST NAME EMPLOYEE # Neil C1755 11-1-17 EFFECTIVE DATE SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ® FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE ❑ MERIT/ STEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ❑ TERMINATION (Provide Separation Info) ® OTHER (Describe Below) ❑ DISCHARGE (D) ❑ RESIGNATION (Q) ❑ RETIRED (R) ❑ LAID OFF (L) ❑ FAIL PROBATION (P) ❑ OTHER (0) ❑ PERFORMANCE (P) ❑ ATTENDANCE (A) ❑ CONDUCT (C) ❑ OTHER EMPLOYMENT (E) ❑ PERSONAL (L) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Increase per wage survey- effective 1-1-17; deferred until February payroll SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE DPA III OCCUPATION CODE 2317 UNION CODE 30 PAY GRADE 217 STEP / POSITION 5 FLSA STATUS ❑ Non -Exempt ® Exempt ❑ Not Covered ❑ Non -Exempt qExempt ❑ Not Covered DRS STATUS ❑ Ineligible ® PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible NPERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 8-15-05 ADJ HIRE DATE 8-15-05 POSITION DATE 8-15-05 LAST RAISE DATE 1-1-16 1-1-17 BASE WAGE $7128. $7434. LONGEVITY $0 $ FTE ® 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% R) 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $7128 $7434. PAYMENT METHOD ❑ HOURLY ® MONTHLY []HOURLY 1)4 MONTHLY DEPARTMENT Prosecutor BUDGET NUMBER A.001290351001 %:100 B. %: A. B. %: %: WORKWEEK ® Standard ❑ ALT/1" Friday off: ❑ 207(k) ❑ Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to 1011. ALLOWANCE (Detail in Comments Section) $0 $ STIPEND (Detail in Comments Section) $0 $ OTHER (Detail in Comments Section) $0 $ SECTION 4: SIGNATURES (MUST BE SIWD IN BLUE INK) DEPARTME D I EtECTED60,116,4L f . - DATE BUDGETIPAYR. LL DATE HMAN,8 OURCE DATE COMIVII T Co 2ATE COM _ 1.3 RETURN FORM TO HUMAN RESOD S FOR DISTRI9U71ON C1 Updated: 04/08/11 FOR HR USE: NT Update EvalDate EvalRating(IE— ID—S—AA—S) Initial C� ' KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) LAST NAME Hartung SECTION 1: EMPLOYEE DATA _ FIRST NAME EMPLOYEE # EFFECTIVE DATE Stephanie H A (off d SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION ❑ DISCHARGE (D) ❑ RESIGNATION (Q) ❑ RETIRED (R) ❑ LAID OFF (L) ❑ FAIL PROBATION (P) ❑ OTHER (0) REASON FOR SEPARATION ❑ PERFORMANCE (P) ❑ ATTENDANCE (A) ❑ CONDUCT (C) ❑ OTHER EMPLOYMENT (E) ❑ PERSONAL (L) ❑ OTHER (0) 0 FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE ❑ MERIT/ STEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ❑ TERMINATION (Provide Separation Info) ® OTHER (Describe Below) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Increase per wage survey- effective 1-1-17 until February payroll dtkt fe� SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE DPA II OCCUPATION CODE 2315 UNION CODE 30 PAY GRADE 215 STEP / POSITION 5 FLSA STATUS ❑ Non -Exempt ® Exempt []Not Covered ❑ Non -Exempt Lpi Exempt ❑ Not Covered DRS STATUS ❑ Ineligible ® PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 2-15-16 ADJ HIRE DATE 2-15-16 POSITION DATE 2-15-16 LAST RAISE DATE 2-15-16 BASE WAGE $5115. $6168. LONGEVITY $0 $ FTE ® 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $5115. $6168. PAYMENT METHOD ❑ HOURLY ® MONTHLY ❑ HOURLY ONTHLY DEPARTMENT Prosecutor BUDGET NUMBER A.001290351001 %:100 B. %: A. is B. %: WORKWEEK ® Standard ❑ ALT/I" Friday off: ❑ 207(k) ❑ Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $0 $ STIPEND (Detail in Comments Section) $0 $ OTHER (Detail in Comments Section) $0 $ SECTION 4: SIGNATURES (MUST BE SIGNED IN §WE INK) DEPARTME D / ELECTE FFI DATE BUDGET/PAYROLL I ! DATE HUM NIR L1�lCE` DATE COMMIS11OAU ❑ NER$1 ` DATE `— COMMI RI �r A E ` � ■ RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update EvalDate EvalRating(IE– ID–S–AA–S) Initial C� '+ KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) LAST NAME Hammond SECTION 1: EMPLOYEE DATA FIRST NAME EMPLOYEE # EFFECTIVE DATE Jodi H2302 1-1-17 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ® FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE ❑ MERIT/ STEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ❑ TERMINATION (Provide Separation Info) ® OTHER (Describe Below) ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ RETIRED (R) ❑ CONDUCT (C) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ OTHER (0) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Increase based on wage survey- effective 1-1-17; deferred until February payroll SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE DPA III OCCUPATION CODE 2317 UNION CODE 30 PAY GRADE 217 STEP / POSITION 5 FLSA STATUS ❑ Non -Exempt ® Exempt ❑ Not Covered ❑ Non -Exempt qExempt ❑ Not Covered DRS STATUS ❑ Ineligible ® PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible PPERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 7-8—I1 ADJ HIRE DATE 7-8-11 POSITION DATE 10-1-15 LAST RAISE DATE 1-6-17 1-1-17 BASE WAGE $6540 $6770 LONGEVITY $0 $ FTE ® 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $6540 $6770 PAYMENT METHOD ❑ HOURLY ® MONTHLY ❑ HOURLY [J MONTHLY DEPARTMENT Prosecutor BUDGET NUMBER A.120290151001 /:100 B. %: A. is B. %: WORKWEEK ® Standard ❑ ALT/1" Friday off: ❑ 207(k) ❑ Standard ❑ ALT/1s` Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $25 $ STIPEND (Detail in Comments Section) $0 $ OTHER (Detail in Comments Section) $0 $ SECTI 4: SIGNATURES (MUST BE SIGNED IN BLUE INK) DEPART AD/ LECTIVUPFICIAL DATE BUDGET/PAYR L DATE 2-F! h UMA"ESOIJRCE MM #2 — DATE COMMI til T 7 f DATE COM . MMN 4 TE 2 1 { RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update Eval Date Eva[ Rating (IE—ID—S—AA—S) Initial C� ' KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) LAST NAME George SECTION 1: EMPLOYEE DATA FIRST NAME EMPLOYEE # EFFECTIVE DATE Erika G2702 1-1-17 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ® FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE ❑ MERIT/ STEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ❑ TERMINATION (Provide Separation Info) ® OTHER (Describe Below) ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ RETIRED (R) ❑ CONDUCT (C) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ OTHER (0) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Increase per wage survey, effective 1-1-17; deferred until February payroll SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE DPA Il OCCUPATION CODE 2315 UNION CODE 30 PAY GRADE 215 STEP / POSITION 5 ❑ Non -Exempt ® Exempt ❑ Not Covered ❑ Non -Exempt (A Exempt ❑ Not Covered FLSA STATUS DRS STATUS ❑ Ineligible ® PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible R PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 6-14-16 ADJ HIRE DATE 6-14-16 POSITION DATE 6-14-16 LAST RAISE DATE 6-14-16 1-1-17 BASE WAGE $4703 $5317 LONGEVITY $0 $ FTE ® 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% 'R 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $4703 $5317 PAYMENT METHOD ❑ HOURLY ® MONTHLY ❑ HOURLY ID MONTHLY DEPARTMENT Prosecutor BUDGET NUMBER A.001290151001 %:100 B. %: A. is B. %: WORKWEEK ® Standard ❑ ALT/1" Friday off: ❑ 207(k) ❑ Standard ❑ ALT/I" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $25 $ STIPEND (Detail in Comments Section) $0 $ OTHER (Detail in Comments Section) $0 $ I SECTION 4: SIGNATURES (MUST BE SIGNED IN BLUE INK) DEPARTMJ:N' AD / ELE F AL DATE BUDGET/PAY �/ 1DATE HUMAN RESOURCE V !]ATE COMMISSI DATE C I#2 U 1 COMMSAATE RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update EvalDate EvalRating(IE— ID—S—AA—S) Initial C� KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) LAST NAME Raap SECTION 1: EMPLOYEE DATA FIRST NAME EMPLOYEE # Robin R0145 EFFECTIVE DATE 1-1-17 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ® FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE ❑ MERIT/ STEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ❑ TERMINATION (Provide Separation Info) ® OTHER (Describe Below) ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ RESIGNATION (OL) ❑ ATTENDANCE (A) ❑ RETIRED (R) ❑ CONDUCT (C) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ OTHER (0) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Increase per wage survey- effective 1-1-17; deferred until February payroll SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE Office Administrator OCCUPATION CODE 1313 UNION CODE 30 PAY GRADE 113 STEP / POSITION 6 FLSA STATUS ❑ Non -Exempt ® Exempt ❑ Not Covered ❑ Non -Exempt Exempt ❑ Not Covered P DRS STATUS ❑ Ineligible ® PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible jP PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 1-23-91 ADJ HIRE DATE 1-23-91 POSITION DATE 5-1-04 LAST RAISE DATE 1-1-16 1-1-17 BASE WAGE $4200. $4620. LONGEVITY $0 $ FTE ® 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% M 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $4200 $4620 PAYMENT METHOD ❑ HOURLY ® MONTHLY []HOURLY OQ MONTHLY DEPARTMENT Prosecutor BUDGET NUMBER A.00129015001 %:100 B. %: A. B. %: %: WORKWEEK ® Standard ❑ ALT/1'` Friday off: ❑ 207(k) ❑ Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to 11011. ALLOWANCE (Detail in Comments Section) $0 $ STIPEND (Detail in Comments Section) $0 $ OTHER (Detail in Comments Section) $0 $ SECTION 4: SIGNATURES (MUST BE SIGNED IN BLUE INK) DEPART D / ELE ICIAL DATE —ji;,- BUDGET/P . RO L D TE 1 HU. ftii SOUR/2 L • C7 COMNii55 p D T CO E #2 DATE E . o COM DAT k�. RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update Eval Date EvalRating(IE— ID—S—AA—S) Initial C4, KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) LAST NAME Doremus SECTION 1: EMPLOYEE DATA FIRST NAME EMPLOYEE # EFFECTIVE DATE Erika D2645 J 1-1-17 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ® FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (5) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE ❑ MERIT/ STEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) ❑ TERMINATION (Provide Separation Info) ® OTHER (Describe Below) ❑ DISCHARGE (D) ❑ RESIGNATION (Q) ❑ RETIRED (R) ❑ LAID OFF (L) ❑ FAIL PROBATION (P) ❑ OTHER (0) ❑ PERFORMANCE (P) ❑ ATTENDANCE (A) ❑ CONDUCT (C) ❑ OTHER EMPLOYMENT (E) ❑ PERSONAL (L) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Increase per wage survey- effective 1-1-17; deferred until February payroll. SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE DPA I OCCUPATION CODE 2314 UNION CODE 30 PAY GRADE 214 STEP / POSITION 5 FLSA STATUS ❑ Non -Exempt ® Exempt ❑ Not Covered ❑ Non -Exempt U9 Exempt ❑ Not Covered DRS STATUS ❑ Ineligible ® PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible 10 PERS ❑ LEOFF ❑ PSERS ❑ Other I HIRE DATE 9-14-15 ADJ HIRE DATE 9-14-15 POSITION DATE 9-14-15 LAST RAISE DATE 1-1-16 1-1-17 BASE WAGE $4135 $4552 LONGEVITY $0 $ FTE ® 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% 1.3100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $4135 $4552 PAYMENT METHOD ❑ HOURLY ® MONTHLY ❑ HOURLY MONTHLY DEPARTMENT Prosecutor BUDGET NUMBER A.001290151001 %:100 B. %: A. %: B. %: WORKWEEK 7w standard ❑ ALT/1" Friday off: ❑ 207(k) ® Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $25 $ lei ey STIPEND (Detail in Comments Section) $0 $ OTHER (Detail in Comments Section) $0 $ SECTION 4: SIGNATURES (MUST BE SIGNE BLUE INK) DEPARTME D / ELECTED WWML DATE BUDGET/P OL TE HU AN R CE_ DATE tl COMMFS530 DATE 12 k E DATE COMMIS u \ �ID�E'/� RETURN FORM TO HUMAN RESOURCES FOR DISTRIMITION Updated: 04/08/11 FOR HR USE: NT Update EvalDate EvalRating(IE— ID—S—AA—S) Initial QA KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) Updated: 04/08/11 FOR HR USE: NT Update EvalDate Eval Rating (IE—ID—S—AA—S) Initial SECTION 1: EMPLOYEE DATA LAST NAME Jurgens FIRST NAME Kathy EMPLOYEE # J0040 EFFECTIVE DATE 01/01/2017 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION ❑✓ FULL-TIME (1) ❑ PART-TIME (2) El PART-TIME (3)I�FP ❑ TEMPORARY (4) ❑ CASUAL (S) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) TERMINATION (Provide Separation Info) THER (Describe Below) t ❑ DISCHARGE (D) ❑ PERFORMANCE (P) E RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ RETIRED (R) ❑ CONDUCT (C) ❑LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ OTHER (0) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Increase per wage survey- payment effective 01/01/17; deferred until February payroll. Interim -stipend to continue until March 1st. SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE FINANCE SYSTEM MANAGER OCCUPATION CODE 2362 UNION CODE 30 PAY GRADE 262 STEP / POSITION 5 FLSA STATUS E Non -Exempt ❑� Exempt ❑ Not Covered ❑ Non -Exempt ❑� Exempt ❑ Not Covered DRS STATUS ❑ Ineligible 0 PERS ❑ LEOFF E PSERS E Other ❑ Ineligible El PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 8/20/1979 ADJ HIRE DATE 8/20/1979 POSITION DATE 11/13/1992 LAST RAISE DATE 1/1/2016 I 1 BASE WAGE $ 5,692.00 $ 6,261.00 LONGEVITY $ 0.00 $ FTE 0100% El ❑ 75% ❑ 60% ❑ SO% E 100% E 80% E 75% E 60% ❑ 50% FTE WAGE $ 5,692.00 $ 6,261.00 PAYMENT METHOD ❑ HOURLY E� MONTHLY E HOURLY ❑� MONTHLY DEPARTMENT PUBLIC WORKS BUDGET NUMBER A. 000 RA3376 %: 100.00 B. -%: A. %.- B. %: :s. WORKWEEK 0 Standard ❑ ALT/1" Friday off: _E3207(k) El Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $ 0,00 $ 0,00 STIPEND (Detail in Comments Section) $ 500.00 S , Q OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES (MUST BE SIGNED IN BLUE INK) q PARTMENT HEAD / ELECTED OFF CIAt DATE Wvt-- BUDGET/ YROL D. TE H A I DATE COM MI 1 DAT C!—m DAF '2 I . t CONI N A / RETURN FORM TO HUMAN RESOUR ES FOR DISTRIBUTrON Updated: 04/08/11 FOR HR USE: NT Update EvalDate Eval Rating (IE—ID—S—AA—S) Initial Ok �', KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) Updated: 04/08/11 FOR HR USE: NT Update Eval Date Eval Rating (IE—ID—S—AA—S) Initial SECTION 1: EMPLOYEE DATA LAST NAME Bacon FIRST NAME EMPLOYEE # EFFECTIVE DATE Kelly B1480 1/01/2017 SECTION 2: TYPE OF ACTION EMPLOYEE TYPE EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION Q FULL-TIME (1) ❑ PART-TIME (2) ❑ LIMITED PART-TIME (3) ❑ TEMPORARY (4) ❑ CASUAL (S) ❑ SEASONAL (6) ❑ PROJECT (7) ❑ WORK STUDY (8) ❑ VOLUNTEER (9) ❑ NEW HIRE ❑ RE -HIRE -®-lvf M17STEP ❑ POSITION CHANGE (Describe Below) ❑ BUDGET CHANGE (Describe Below) ❑ LEAVE (List Type Below) QJERMINATION (Provide Separation Info) 91THFR (Describe Below) ❑ DISCHARGE (D) ❑ PERFORMANCE (P) ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) ❑ RETIRED (R) ❑ CONDUCT (C) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) ❑ OTHER (0) ❑ OTHER (0) ❑ Eligible For Rehire ❑ Ineligible For Rehire Provide Details of Separation Below COMMENTS: Increase per wage survey - payment effective 1/1/17; deferred until February payroll. SECTION 3: POSITION DATA Enter existing data from CAMAS Wage Data Report Enter new data JOB TITLE ENGINEER TECHNICIAN I OCCUPATION CODE 2425 UNION CODE 40 PAY GRADE 225 STEP / POSITION 6 FLSA STATUS E Non -Exempt ❑ Exempt ❑ Not Covered Q Non -Exempt ❑ Exempt ❑ Not Covered DRS STATUS ❑ Ineligible [j] PERS ❑ LEOFF ❑ PSERS ❑ Other ❑ Ineligible [j] PERS ❑ LEOFF ❑ PSERS ❑ Other HIRE DATE 7/5/2002 ADJ HIRE DATE 7/5/2002 POSITION DATE 6/25/2007 LAST RAISE DATE 1/1/2016 BASE WAGE $ 3,631.00 $ 4,428.00 LONGEVITY $ 0.00 $ FTE 0 100% ❑ 80% ❑ 7s% ❑ 60% ❑ so% p l00% ❑ 80% ❑ 75% ❑ 60% ❑ 50% FTE WAGE $ 3,631.00 $ 4,428.00 PAYMENT METHOD ❑ HOURLY Q MONTHLY ❑ HOURLY Q MONTHLY DEPARTMENT PUBLIC WORKS BUDGET NUMBER A. 000 RA3376 %: 100.00 B. %: A. %: B. %: WORKWEEK [j] Standard ❑ ALT/1" Friday off: ❑ 207(k) 0 Standard ❑ ALT/1" Friday off: ❑ 207(k) To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". ALLOWANCE (Detail in Comments Section) $ 0.00 $ 0.00 STIPEND (Detail in Comments Section) $ 0.00 $ 0.00 OTHER (Detail in Comments Section) $ 0.00 $ 0.00 SECTION 4: SIGNATURES (MUST BE SIGNED IN BLUE INK TP RTMENT HEAD E LTE D.0FFICIAL [: DATE LkA P 01 --AID i BUDGETJPA DATE .2 I MA RE OURCE DATE COMMIS DA O CR #2 I Co" TE COM q F RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION Updated: 04/08/11 FOR HR USE: NT Update Eval Date Eval Rating (IE—ID—S—AA—S) Initial