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EXHIBIT A <br />INDIAN RIVER COUNTY <br />NON-UNION EMPLOYEE CELLULAR DEVICE STIPEND <br />AUTHORIZATION FORM <br />Employee Name: <br />Job Title: <br />Stipend Effective Date: <br />Department: <br />Division: <br />❑ NEW ❑ CHANGE ❑ DISCONTINUED <br />JUSTIFICATION (Check all that apply): <br />❑ The employee's job function requires the user to be accessible outside of scheduled or normal <br />business hours. <br />❑ The employee's job function requires the user to be in the field or away from their assigned office <br />or work area regularly and the use of a cellular device is essential in carrying out the essential duties <br />of the job. <br />❑ The employee's job function requires regular voice and/or email contact with their office, outside <br />vendors and/or customers while away from their normal work place. <br />❑ The employee is responsible for critical infrastructure and need to be immediately accessible at all <br />times. <br />Stipend: (check one) ❑ Voice Only ❑ Voice and data <br />$30/month $50/month <br />EMPLOYEE ACKNOWLEDGEMENT: I acknowledge that I have read and understand the County <br />Cellular Device and Stipend Policy and the expectation that the use of the cellular device will be in <br />compliance with County policies and standards of behavior. <br />Employee Signature <br />Date <br />I certify that this device is needed for the employee to perform the essential duties of their job. <br />Department Head Signature <br />Approved: <br />Director,, Office of Management & Budget <br />Date <br />Date <br />W <br />