404 - PAYMENT FOR
EMPLOYEE EQUIPMENT DAMAGED OR STOLEN
The County will replace
or reimburse an employee for the repair or replacement of employee-owned
equipment (other than vehicles damaged
or stolen in the course of work) subject to the following conditions:
1. Claims must be submitted by employees to
their department head within 30 days from the date of loss. No reimbursement will be granted for late
claims.
2. Replacement or
reimbursement will be limited to: (1) health related appliances; (2) tools used
in the course of work; and (3) clothing, for an employee who receives no type
of clothing allowance.
3. Replacement or reimbursement shall not be made
for decorative items or items of convenience to the employee and not needed for
the employee's work.
4. Damage to or loss
of automobiles or other vehicles for which an employee may receive mileage
reimbursement shall not be required, replaced or reimbursed as the private
mileage rate is intended to cover such losses.
5. No reimbursement will be granted for losses covered by some other
source, insurance policy or agency.
6. Claims must be accompanied by a dated sales
receipt, which shows the purchase price and the date of purchase, or some other
means of verifying the value of the damaged property. Copies of canceled checks, charge card receipts, etc., may be
considered.
7. Replacement or reimbursement for items
shall be limited to the depreciated value when depreciation can be ascertained.
8. Only claims with a
value of $10.00 or more will be considered.
9. The maximum amount
of reimbursement or replacement for a loss will be $250 per incident; however,
the maximum amount for watches will be $50.00 and for clothing shall be $75.00.
10. Claims will only be
considered if the employee was engaged in assigned official duties of the
County when the personal property loss was sustained.
11.
Claims will only be considered if the loss was sustained through no
negligence fault of the employee.
12.
Claims based on cash losses or losses due to stolen credit cards will
not be considered.
13. When damage to clothing or
health-related appliances is related to a personal, on-the-job injury, the
items are replaced under worker's compensation.
14.
The Personnel Director's findings on any claim shall be final and
binding.
PROCEDURE
Who Action
Employee 1. Completes County Personal Property
Reimbursement Claim Form.
2. Submits
completed Claim Form, with all required attachments, to department head.
Department Head 3. Reviews Claim Form for
adherence to policy, and recommends approval or denial of claim. If approval is
recommended, has Blue Claim Form prepared for appropriate budget unit and line
item.
4. Forwards Claim Form and
Blue Claim to Personnel Director.
Personnel
Department 5. Reviews claim
for conformance to policy.
6. Documents whether or not
each requirement of the policy has been met.
7. When possible,
determines depreciated value of item(s) and documents.
8. Approves or denies
claim. If denied, provides basis.
9. Forwards copy of
Claim Form and work sheet to employee.
10. If approved, forwards one copy of Claim Form and Blue Claim to
Auditor's office to provide either:
a. Reimbursement to employee;
or
b. Purchase by
department of replacement item(s).
COUNTY OF SANTA
CRUZ
COUNTY EMPLOYEE PERSONAL PROPERTY
REIMBURSEMENT CLAIM FORM
NAME
DEPT.
WORK
WORK LOCATION PHONE
NAME OF EMPLOYEE'S
IMMEDIATE SUPERVISOR
DATE AND TIME OF LOSS
LOCATION OF LOSS
DESCRIBE WHAT YOU WERE
DOING WHEN THE LOSS OCCURRED:
ATTACH
COPIES OF DOCUMENTATION, SUCH AS POLICE REPORTS, SALES SLIPS AND INSURANCE
CLAIMS.
I
certify that the information provided is correct, and that the loss claimed is
not covered by any other source, insurance policy or agency.
SIGNATURE OF
EMPLOYEE DATE
SEE PROCEDURES MANUAL
SECTION 404 FOR DEADLINES, POLICY AND
PROCEDURES (attached) AND SUBMIT
COMPLETED CLAIM TO YOUR DEPARTMENT HEAD.
TO BE COMPLETED BY DEPARTMENT HEAD OR
REPRESENTATIVE
DATE OF CLAIM RECEIVED
RECOMMENDED:
APPROVAL DENIAL OF CLAIM.
DEPARTMENT HEAD
SIGNATURE DATE