LCHR 46_Guiding Principles Cash Bonus Request

Cash bonuses may be awarded when an employee’s action or behavior exemplifies one or more of the guiding principles. Employees are encouraged to bring the action or behavior to the attention of their supervisor and for the supervisor to bring it to the attention of the Decision Maker so a guiding principle bonus may be considered. Only one Guiding Principle cash bonus may be awarded per calendar year, per employee. A cash bonus may be requested by completing this form. Read the full policy here.

Person Making This Request *

Requestor Email *

Employee Name *

Employee Number

Department/Office *

Supervisor Name *

Select the range for the bonus *

Cash Bonus Amount Requested *

Select applicable guiding principle(s) associated with this bonus request *

	Being good stewards of public resources
	Promoting innovation, adaptability, and committing to continuous improvement
	Providing consistent quality customer service
	Empowering people to take responsiblity
	Cultivating inclusive and collaborative partnerships
	Being a fulfilling, enjoyable, and inclusive place to work

Details regarding request, including how it is connected to selected guiding principle(s). *

Select department/office to determine form routing to the Decision Maker and Payroll Representative.

Department/Office for Routing *

Decision Maker Name

Decision Maker Email

SODM DNU

Primary Payroll Rep Name

Primary Payroll Rep Email

Backup Payroll Rep Name

Backup Payroll Rep Email

County Manager

County Manager Email

Assistant County Manager

Assistant County Manager Email

Support Services Director

Support Services Director Email

Submitter is Decision Maker

Decision Maker Approval *

	Approved
	Denied

Basis for Decision *

Guiding Principles Decision *

	Approved
	Denied

Basis for Decision *

Guiding Principles Representative Signature

Date Signed

County Manager Decision

	Approved
	Denied

Basis for Decision

County Manager Signature

Date Signed

Submit