MESA POLICE DEPARTMENT

TEMPORARY EMPLOYMENT AGREEMENT

TO BE COMPLETED BY ALL EMPLOYERS

NAME OF POTENTIAL EMPLOYER : ___________________________________________

NAME OF BUSINESS : ________________________________________________________

BUSINESS ADDRESS : ________________________________________________________

PHONE NUMBER : ___________________________________________________________

FAX NUMBER : ______________________________________________________________

NAME OF SITE SUPERVISOR : ________________________________________________

Estimated length of temporary Employment : _______________________________________

Start Date;__________________________                Start Time; ________________________

End Date : _________________________                End Tie : _________________________

Number of Officers Requested : __________________________________________________

Location of job site:____________________________________________________________

Person to contact at job site : ____________________________________________________

Phone Number of Contract Person : ______________________________________________

TYPE OF WORK: (CHECK ONE) traffic control : __________________ security: ________

Any establishment whose primary source of income is from liquor must provide a description job duties to be performed by the Mesa Police Department (MPD)

MEMBER.

1. Payment is required before the start of job. If payment is NOT received before start of

job, MPD Officers, (Sworn Officers, Municipal Security Officers or Police Service Officers)

2. , The MPD Officer’s acceptance of employment is conditioned upon approval of the Chief of police.

3. MPD Officer’s working conditions and demeanor are subject to onsite inspection and review by the Mesa Police Department.

4. Any employment of uniformed Off-Duty MPD Officers MUST be arranged with the Off Duty Hiring Coordinator of the Mesa Police Department. The Mesa Police Department

reserves the right to cancel or terminate any Off-Duty work agreement or engagement in

emergency and other situations as determined by the Chief of Police or designee.

5. MPD Officers are considered to be employees of the above listed temporary employer for

the purposes of the Arizona Worker’s Compensation Laws and any injuries resulting from

such employment shall be the responsibility of the named temporary employer.

6. The temporary employer will cooperate fully in the prosecution of any arrests resulting

Temporary

7. Police related temporary employment is authorized ONLY within the boundaries of the

City.

8. Temporary employers MUST purchase and maintain insurance, as evidenced by

Certificate of Insurance BEFORE temporary employment begins, as prescribed by City

Ordinance with the CITY OF MESA AND/OR MESA POLICE DEPARTMENT listed as

the certificate holder or insured:

1. Commercial general liability insurance with a one million ($1,000,000) dollar per

Currence limit for product and completed operations, premises liability personal

And contractual liability for the liability assumed under this agreement. Such shall include false arrest, false imprisonment, violation of civil rights and libel and shall include false arrest, false imprisonment, violation of civil rights and libel and slander

2. Statutory workers’ compensation insurance and employers’ liability of $500,000.00 policy

9. The fee for Off Duty MPD Officers will be according to the following schedule and stipulations

sworn police                                                                 $40.00 per hour

officer

Police Service officer                                                         $35.00 per hour

(PSO)                                                                        $40.00 per hour

                                                                        $25.00 per hour

MSO Supervisor ( when 4 or more MSOs are needed)                $29.00 per hour

1. The Mesa Police Department reserves the right to increase the Off Duty Rate of pay upon .
2. Vendors who do not agree with the rate change can cancel the Agreement, upon written. Notice with in 14 days of receipt of the written notice of rate increase,  ** I have to read and understand section A and B above (initials required)

Traffic Control: When roadway construction or traffic control is needed and the MPD Officer is stationed in the roadway and/or the job impedes the flow of traffic, a fully marked police vehicle will be required and billed separately at the rate of $5.00 per hour for the duration of the job.

Cancellation: 24 hours cancellation notice is required in writing, otherwise the minimum (3

hours) will be paid to the officer. 72 hours notice is needed prior to hiring any Officer unless

exigent circumstances exist.

POTENTIAL TEMPORARY

EMPLOYER’SCERTIFICATION

I have read, understand and agree to the conditions for employment outlined in this agreement.

**I have read and understand the approved duties of Mesa Police Department members

as outlined in Mesa Police Department Administrative Order ADM 772. (Only required for

establishments whose primary source of income is from liquor sales).

Signature of Temporary Employer                                                 Date

Approved                 Not Approved         

Chief of Police or designee (Temporary employment at liquor establishment)

                                                                                Date

Please forward this form to Vicki Keast, Off-Duty Hiring Coordinator

Mesa Police Department – P. O. Box 1466 – Mesa, Arizona 85211

Phone (480) 644-2092 – Fax (480) 644-8114