Exhibit	No. 3513.1(2)

CLOVIS UNIFIED SCHOOL DISTRICT

ALLOWANCE AGREEMENT FOR MOBILE DEVICE SERVICE (USE FOR POSITIONS NOT DESIGNATED ON EXHIBIT 3513.1(1))
Please Print:

Employee Name:	 Employee ID #:	

School Site/Department:	 Position:	

Allowance Effective Date:	 Device Phone Number:	

Munis Account Code: 59000X-	-	-	-	-	- -	-	

NOTE: Cellular phone allowances will be charged to the same budget(s) as the employee’s salary. This agreement must be submitted to the Payroll Department by the 15th of the month to be included on the end-of-the month payroll.

EMPLOYEE CERTIFICATION:

I certify that the allowance will be used toward expenses that I incur for cellular phone usage for District business purposes. I further certify that should I cancel or deactivate a service, I will notify my supervisor and the Payroll Department within five (5) days to discontinue the allowance payment. I acknowledge that I am personally responsible for complying with any contract entered into with a service provider and in the event that I should leave the District, I will continue to be responsible for the contractual obligations of the service plan. I will adhere to the District’s annual random audit process. I further acknowledge that the allowance amount will be taxable for personal income tax purposes and all charges above the allowance provided will not be reimbursed by the District. Should I move to another site or department, I will notify my new supervisor of the allowance and/or device. I acknowledge that if my position and/or responsibilities change, the need for an ongoing allowance shall be re-evaluated.

Employee Signature	Date

School Site Principal/Department Director Approval	Date

Assistant Superintendent Approval	Date

Associate/Deputy Superintendent Approval	Date Distribution: Original: Payroll Department

Adopted: 05/14/2008 Reviewed: 01/28/2009
Amended: 11/29/2010, 04/22/2020 (EXH 4204(1) renumbered as EXH 3513.1(2))

Doc# 36441-4 (10/2019, None)

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