HomeMy WebLinkAboutSafety Shoe Policy FormCity of Cape Canaveral
Safety Equipment
Policy Amendment
January 23, 2017
I acknowledge that I am required to comply with all provisions and guidelines stated in the City's
Safety Policy to include the use of safety equipment when performing work for the City.
Effective January 23, 2017, employees eligible for a $100 per year non-taxable Shoe Allowance
will receive, in advance, the allowance direct deposited on one of the following dates.
• On or near employee's anniversary of hire date OR
• One year from date of last Shoe Allowance expenditure.
Upon deposit of Shoe Allowance, employee is required to purchase shoes (ASTM compliant, steel
or composite toe) from a vendor of their choosing and forward receipt for shoe purchase to the
Finance Department within 30 days. Employee is expected to use all or near the full shoe
allowance for safety shoes.
If employee fails to show evidence of their safety shoe purchase within 30 days, the $100 Shoe
Allowance will be deducted from their pay and no new allowance will be issued that year.
Employees with less than 1 year of service, who for any reason terminate employment from the
City, will have the $100 Shoe Allowance deducted from their final pay.
have read and agree with the terms and
Printed Employee Name
conditions detailed in this Safety Equipment Policy statement.
Employee Signature
Date
RETURN COMPLETED FORM TO HUMAN RESOURCES