SD 314.1, NNSA Telework Plan

CONTROLLED DOCUMENT OFFICE OF PRIMARY INTEREST (OPI): AVAILABLE ONLINE AT: Human Resources https://nnsa.energy.gov/aboutus/ouroperations/managementandbudget/supplementaldirectives printed copies are uncontrolled SUPPLEMENTAL DIRECTIVE Approved: 5-15-17 NNSA TELEWORK PLAN NATIONAL NUCLEAR SECURITY ADMINISTRATION Management and Budget NNSA SD 314.1 https://nnsa.energy.gov/aboutus/ouroperations/managementandbudget/supplementaldirectives THIS PAGE INTENTIONALLY LEFT BLANK NNSA SD-314.1 1 5-15-17 NNSA TELEWORK PLAN 1. PURPOSE. This Supplemental Directive (SD) to DOE Order 314.1, DOE-Flex: DOE's Telework Program serves as the NNSA Telework Plan required by the DOE Order. This SD establishes requirements and responsibilities for administering NNSA’s telework program and is meant to be used in conjunction with the DOE Order and the DOE Desk Reference on DOE-Flex. 2. CANCELLATION. This SD cancels section 3.c.13), “Telecommuting (Flexiplace)”, of BOP-002.06, National Nuclear Security Administration Leave Administration and Hours of Duty, dated 03-13-09, and the Handbook for Flexiplace in National Nuclear Security Administration Headquarters, dated September 2005. 3. APPLICABILITY. Federal. This directive applies to all NNSA Federal employees. Contractors. Does not apply to contractors. Equivalency. None. 4. SUMMARY OF CHANGES. Replaces the use of “telecommuting” and “flexiplace” with “telework” or “teleworking.” Removes the requirement that telework requests be approved for an entire workday or more. (Employees may telework for a portion of the day then travel to the official duty station in the same day.) Changes “essential employee” to “emergency employee.” Provides information on required training for employees and supervisors; telework request, approval, recertification, and grievance procedures; equipment; closures, etc. Adds additional responsibilities to Section 7, Responsibilities. 5. BACKGROUND. Telework is an arrangement in which an employee works at an alternative worksite, such as the employee’s home, a telework center, or other location that allows the employee to accomplish work in an effective and efficient manner. In 1990, the Federal Government began piloting alternative worksite arrangements that were known as Flexiplace arrangements. For many years, laws addressing telework (under various names – “work at home,” “flexible work,” “telecommuting,” etc.) have been in effect for Federal employees. https://www.directives.doe.gov/directives-documents/300-series/0314.1-BOrder https://www.directives.doe.gov/directives-documents/300-series/0314.1-BOrder http://energy.gov/hc/downloads/desk-reference-doe-flex http://energy.gov/hc/downloads/desk-reference-doe-flex 2 NNSA SD-314.1 5-15-17 The Telework Enhancement Act of 2010 was signed into law on December 9, 2010. This law continues to encourage Federal agencies to use telework as a workforce flexibility for recruiting top talent; retaining current employees; providing reasonable accommodations for employees; reducing the cost of office space and absenteeism; and responding to emergency situations/office closures. Telework also enables employees to better manage work and personal or family responsibilities, while reducing commuting time, traffic congestion, fuel consumption, and dangerous vehicular emissions. Participation in the telework program is voluntary. 6. REQUIREMENTS. General.

Note: Telework is not an employee right. Federal law requires agencies to establish telework programs without granting individual employees a legal right to telework. If eligible, participation is subject to the supervisor’s/manager’s determination as to the type of arrangement(s), situation(s), and frequency that an employee or group of employees may telework. Management must guarantee that participation does not diminish the employees’ performance or the agency’s operations. Telework must not be used as a substitute for dependent care. Although telework is not a substitute for primary caregiving, there are circumstances in which an employee could work at home and still provide needed care on a limited basis to a family member. For example, an older child may be on bed rest and may only need administration of medication periodically; in this scenario, the employee is able to conduct work throughout the day. Having a small child who is ill and requires constant attention would not be a situation where the employee could telework. Sick leave or annual leave would be appropriate in this situation. Teleworking generally requires computer connectivity to be productive. If for any reason employees lose connectivity, they should notify their supervisor. If the employees have no other work that can be performed, and the issue is not resolved within an hour, they must travel to the duty site or request leave. Eligibility. All NNSA employees, including supervisors and managers, regardless of duty station, will be considered eligible to telework unless one of the exclusions in Section 6c. is met, as determined by the supervisor on a case-by-case basis. The determination must be certified on the Employee Telework Eligibility Notice/Application (Appendix 5) at the time the employee provides an application for telework. NNSA SD-314.1 3 5-15-17 Although an employee may be eligible to telework, any employee who wishes to participate must first successfully complete an interactive telework training program provided by the agency and must enter into a written agreement with the supervisor. Managers and supervisors may not compel an employee to participate in telework, even if the duties of the position make the employee telework eligible. An employee (who either does not wish to telework or is not eligible to telework) cannot be forced to sign a telework agreement (Appendix 7) for any reason, e.g., in order to avoid providing an excused absence to an employee on a day when federal offices are closed to the public. Both employee participation and the signing of a telework agreement (Appendix 7) must be voluntary. Although entering into the telework arrangement is voluntary, once employees are under such an arrangement, they may be required to telework outside of their normal telework schedule. For example, when the Federal Government is closed, employees with a telework agreement (Appendix 7) are expected to work to the extent feasible (see Section 6.r.(1), Emergency, Closure, or Dismissal). Also these employees may request unscheduled telework for personal situations or emergencies. Exclusions. If the employee is deemed ineligible to telework, the business reason must be based on the following exclusions. The determination of ineligibility must be provided to the employee and documented on the Employee Telework Eligibility Notice/Application (Appendix 5) at the time the employee provides an

application for telework. The limitations on eligibility as set forth below (even in emergency or other unforeseen situations) are not intended to be an exhaustive listing of all reasons for limiting or restricting telework. The employee has not been in the organization long enough to know their duties or organizational relationships well enough to perform independently or successfully unless in the office. The employee’s capability to access the network does not meet the network security requirements and no other work of equal or higher priority that is acceptable to the supervisor can be performed at an alternative worksite. The position involves only work that is performed at offsite locations or while traveling between worksites, such as the transport of nuclear materials. The employee’s performance has been evaluated at less than the Fully Meets Expectations (FME) level. (If the employee’s performance is 4 NNSA SD-314.1 5-15-17 improving while subject to a Performance Concern Memorandum (PCM), Performance Assistance Plan (PAP), or Performance Improvement Plan (PIP), they may be approved to telework during an emergency situation. Per DOE O 314.1,4.b.(6) the employee must be on a situational telework agreement that is limited to emergency situations in order to perform work offsite in this situation). The position involves work that is normally restricted to being performed onsite every day; for example, work involving the handling of classified information or frequent and recurring face-to-face contact. The employee may be approved to perform work offsite during emergency/closure situations, and must be on a situational telework agreement that is limited to emergency/closure situations in order to perform the work offsite. The employee has previously been removed from telework for lack of reliability, e.g., loafing, unresponsiveness, missing in action, wasting time, other computer misuse, etc. The employee has been officially disciplined, and a discipline document has been placed in employee’s official personnel file (OPF) for (a) being absent without permission for more than five days in any calendar year; or (b) violation of subpart G of the Standards of Ethical Conduct for Employees of the Executive Branch for viewing, downloading, or exchanging pornography, including child pornography, on a Federal Government computer or while performing official Federal Government duties. The employee will be prohibited from participation in telework as long as the discipline document remains in the OPF. Note: An employee designated as an emergency employee may participate in the telework program but must follow reporting requirements in Section 6.s., Continuity of Operations Plan. See section 6.s. for further information. Types of Telework Arrangements. Routine. Employees perform work at another location on a scheduled, recurring basis, e.g., weekly, bi-weekly, or monthly for non-medical reasons. Routine telework agreements may also be used as a reasonable accommodation. The supervisor may direct the employee to be at the organization’s main office or other location on a day or part of a day that the employee would otherwise telework, unless there are extenuating circumstances that would NNSA SD-314.1 5 5-15-17 preclude that from happening or result in the employee requesting leave for the day (e.g., a medical appointment that should not be cancelled).

Notice of the direction to be at the office will be given as far in advance as possible. The employee has no claim to substitute a day or days of telework, unless an alternative day is approved. Situational. This arrangement permits work at the alternative site for short periods of time to accommodate either personal or work situations. Employees perform work to accomplish specific tasks, to complete a work product, or to accommodate a personal situation. The number of hours or days spent teleworking will depend on the situation or nature of the assignment(s). Teleworking for a medical condition (for self or a family member) or reasonable accommodation on an intermittent or periodic basis is also Situational telework. NNSA will use Situational to reflect all non-routine situations except for medical telework arrangements. Supervisors are encouraged to allow as many employees as possible to be placed on Situational agreements (as requested), even if they will only be using it under certain emergency or closure situations. Medical. A medical arrangement is for a definitive period during confinement, rehabilitation, or recuperation from a serious illness or injury. This may be a full-time or part-time arrangement depending on the medical situation. (Note: When telework is approved as a reasonable accommodation it will usually be under a Routine or Situational arrangement.) A medical arrangement is appropriate when the employee is expected to telework due to a medical condition or provide care for a family member with a medical condition throughout a specific period and not on an intermittent basis. Teleworking to attend periodic medical appointments for self or a family member, or to care for a family member for a few days (as long as the employee is able to perform work), are regarded as Situational not Medical arrangements. Note: When caring for themselves or a family member, or going to a doctor’s appointment, the time spent at medical treatments, periodic medical appointments, or receiving/providing medical attention does not count as hours worked. The employee would take sick leave, annual leave, credit hours, etc., as appropriate. A medical telework request must be supported by acceptable documentation from the applicable medical service provider that directly links the family member’s, or employee’s medical condition to the need for telework, and provides a prognosis for the return to full duty or a description of any limiting conditions. The medical documentation must be submitted in the complete telework package. The NNSA Telework 6 NNSA SD-314.1 5-15-17 Coordinator will conduct a policy compliance/administrative review to ensure the documents are properly completed. The documentation must be on the medical provider’s letterhead, dated, and include: (a) Employee’s or family member’s name. (b) Statement that employee or family member is under a physician’s care. (c) Reason the medical condition requires the employee to telework. (d) Anticipated duration of the medical condition (beginning date and ending date of the need to telework). (e) Signature of medical provider. Medical documentation must be filed and maintained by the NNSA Telework Coordinator and the employee’s supervisor. It is not filed in the employee’s OPF. Access to medical documentation will only be permitted per current regulations regarding access to medical

documentation. The reason for medical telework is kept confidential and is only disclosed on a need-to-know basis. The duration of a medical arrangement is determined by the period specified by the medical service provider. It may be extended or reduced, depending on the circumstances. When an extension is being requested, updated medical documentation must be provided to the supervisor and the NNSA Telework Coordinator for compliance/administrative review. Reasonable Accommodation. Telework may be considered appropriate as an accommodation for employees who meet reasonable accommodation guidelines in accordance with Equal Employment Opportunity (EEO) regulations and NNSA Policy. When telework is approved as an accommodation it will usually be under a Routine or Situational arrangement. Employees must comply with telework requirements with any applicable modifications based on the accommodation. It is important to distinguish between ordinary requests to telework and requests for reasonable accommodations from persons with disabilities, because telework is governed by the telework laws and reasonable accommodations are governed by Section 501 of the Rehabilitation Act of 1973 (Rehab Act), as amended, 29 USC § 791 et seq. (which was made applicable to Federal employees pursuant to the Americans with Disabilities Act). Further information may be obtained at EEOC Work at Home/Telework as a Reasonable Accommodation, Telework.gov/Reasonable Accommodations or from the NNSA Reasonable Accommodations Coordinator. http://eeoc.gov/facts/telework.html http://eeoc.gov/facts/telework.html https://www.telework.gov/guidance-legislation/telework-guidance/reasonable-accommodations/ NNSA SD-314.1 7 5-15-17 Length of Telework Agreements/Number of Telework Days per Pay Period/Partial Days. Routine and Situational agreements may be in effect indefinitely if the employee’s duties or responsibilities do not change a significant amount; the agreement must be reviewed annually (See 6.i). A medical arrangement is for a definitive period during confinement, rehabilitation, or recuperation. The agreement will be in effect only during that period. There is no limit on the number of days in a pay period that an employee is permitted to telework; rather, the days will be determined by the work that can be performed at the telework site and the need for the employee to be at the worksite to interact with person(s) assigning work and with colleagues, attend meetings, etc. The supervisor will make this determination. Note: The number of days worked at the telework site may affect the determination of the official duty station and locality pay. See 6.p., Official Duty Station, for more information. Employees may telework for part of the day and work at the worksite for part of the day as approved. For example, teleworking to attend early morning meetings before going into the office, or working in the office in the morning, leaving the office to attend a personal appointment near home, and then continuing work at the telework site. Note: Travel time between home and work is only creditable as hours of duty if the employee goes directly to/from home and the worksite and commences work (for more information on Commute Time, see Section 6.q.) Suitability for Telework. In determining whether a particular work situation is suitable for telework, supervisors should consider the nature of the work, as well

as the characteristics of the employee. Work. Work suitable for telework depends on job content or work schedule. For example, telework is feasible for work that requires thinking and writing – data analysis, research and writing, reviewing grants or cases, writing decisions or reports; telephone-intensive tasks, such as setting up a conference, obtaining information, or following up on participants in a study; and for computer-oriented tasks – programming, data entry, word processing. Work may not be suitable for telework if the employee needs to have extensive face-to-face contact with the supervisor, other employees, 8 NNSA SD-314.1 5-15-17 clients, or the general public; if the employee needs frequent access to material which cannot be moved from the main office, such as classified documents; if the agency cannot provide any special facilities or equipment that are necessary; or if it would be too expensive for the agency to duplicate the same level of security at the alternative workplace. Employee. The work characteristics of an employee are important. The employee should be an organized, disciplined, and conscientious self- starter who requires minimal supervision. Employees who are not generally considered suitable for telework are new employees who need time to adjust to and learn the organization, or those who require on-the- job training, or need close supervision. A performance rating of Needs Improvement (NI) or below, precludes participation in the telework program; however, if an employee’s performance is improving while under a PCM, PAP, or PIP, the employee may be approved to telework on a situational basis, such as during an emergency, office closure, special project, etc. Training. All employees who telework must be trained before a telework agreement may be signed. Completion of the U.S. Office of Personnel Management (OPM) Telework 101 for Employees Training is required for all employees requesting telework. All supervisors of employees who telework must complete the OPM Telework 101 for Managers Training Supervisors who choose to telework must also complete the OPM Telework 101 for Employees Training A certificate of completion is available after all training elements are completed and must be included in the final telework submission package. Telework training is not required annually. Telework Application Review/Decision. Employees interested in telework must submit a complete telework application package. All telework participants must also have a written telework agreement in place (regardless of whether telework is routine, situational, or medical). The written telework agreement is entered into between the supervisor and the employee authorized to telework; outlines the specific work arrangement that is agreed upon; and must be in place in order for any employee to telework. The complete telework package includes: (a) NNSA Telework Eligibility Notice/Application (Appendix 5); http://www.telework.gov/tools_and_resources/training/employees/index.aspx http://www.telework.gov/tools_and_resources/training/employees/index.aspx https://www.telework.gov/training-resources/ https://www.telework.gov/training-resources/ http://www.telework.gov/tools_and_resources/training/employees/index.aspx http://www.telework.gov/tools_and_resources/training/employees/index.aspx NNSA SD-314.1 9 5-15-17 (b) NNSA Telework Self-certification Safety Checklist (Appendix 6);

(c) NNSA Telework Agreement (Appendix 7); (d) Telework Training certificate of completion; (e) Medical documentation (as applicable); and (f) Any other applicable documentation. All employees must use the applicable NNSA Telework forms attached to this policy and located online on the OneHR site and the Telework page on the NNSA Intranet Portal. The telework application is submitted to the first level supervisor for eligibility review and approval or disapproval. All requests to participate in telework should be acted upon within 20 workdays of submission. If this is not possible, the supervisor will advise the requesting employee of the delay and the revised time of approval or disapproval. The approved package must be submitted to the NNSA Telework Coordinator for policy/administrative compliance review. If the request is disapproved, the reason for the disapproval must be provided to the employee in writing (along with information on grievance procedures) and signed by the supervisor with concurrence by the second level supervisor. The decision to deny a request to telework must be based on organizational needs, operational requirements, and employee performance, not personal reasons. A copy of the disapproved telework application and the reason for the disapproval must be submitted to the NNSA Telework Coordinator. The package must be completed, approved, and signed by the supervisor and employee before the commencement of telework; unless an exigency occurs which precludes the completion of forms before the commencement of telework. In such cases, the forms must be completed within a reasonable period of time appropriate to the circumstances involved. The employee and the supervisor must provide assurance that required telework training (employee and supervisor training) has been completed before preparing and signing the telework agreement, and prior to telework commencing. https://nnsaportal.energy.gov/intranet/na-mb/na-mb-10/flexiplace/SitePages/Home.aspx 10 NNSA SD-314.1 5-15-17 A new telework agreement should be signed and approved when the employee is placed under a new supervisor; however, the new supervisor has the option of leaving the old agreement in place. Annual Review/Recertification. Indefinite agreements (Routine/Situational) should be reviewed by the supervisor at the end of the fiscal year and, if there is a change in the telework situation, recertified. Recertification is noted on the Employee Telework Recertification Form (Appendix 8). Long-term medical agreements should be reviewed periodically, per management’s discretion. Suspension or Termination of Agreement. An agreement may be terminated by the employee at any time, for any reason, by notifying the supervisor, the NNSA Telework Coordinator, and the timekeeper. With the concurrence of the second level supervisor, a supervisor may suspend or terminate an agreement at any time by informing the second level supervisor and the employee in writing of the reasons for the action and the effective date. The Employee Telework Suspension or Termination form (Appendix 9) must be used. The supervisor must also notify the NNSA Telework Coordinator and the timekeeper. When terminating an agreement, employees must be advised of their right to appeal the action through the grievance process. A telework agreement may be suspended for reasons such as: (a) To guarantee training requirements are completed on time.

(b) To attend essential meetings, conferences, etc. (c) To complete critical or urgent assignments requiring the employee's presence at the official duty station. (d) Lack of office coverage (such as during vacation periods or staff shortages). A telework agreement may be terminated for reasons such as: (a) Employee performance beginning to diminish. (b) Reassignment or promotion to a new position not eligible for telework. NNSA SD-314.1 11 5-15-17 (c) Upon permanent recovery of employee from medical issues or disability which necessitated the telework arrangement. (d) Failure to fulfill the terms of the agreement. (e) Failure to maintain eligibility in accordance with DOE Order 314.1 Equipment/Supplies. There is no requirement in the law or DOE telework policy for Departmental elements to provide any resources when an employee is deemed eligible for telework. Each program/field office may provide the necessary equipment from available surplus to the extent feasible. The office is not under any obligation to purchase extra equipment or supplies for this purpose, but it will not deny equipment to those who may need it, provided the equipment is available at no cost and use of supplies is reasonable. Documentation of equipment or supplies assigned to the employee is made on the Telework Agreement (Appendix 7), Section 2.d. If equipment cannot be provided from available supply (including surplus), employees who wish to participate in telework will have to provide it themselves. Participants who use their own equipment must ensure that adequate safeguards exist to protect the equipment and records. Information Systems and Technology Security. When teleworking, employees must continue to follow the requirements of all information/record systems and technology-related policy and guidance including, but not limited to, DOE O 202.1B, Department of Energy Cyber Security Program; DOE O 203.2, Mobile Technology Management; DOE O 243.1B, Records Management Program; DOE O 203.1, Limited Personal Use of Government Office Equipment Including Information Technology; NNSA SD 243.1, Records Management, and all related references listed therein. The processing offsite of unclassified sensitive data must be in accordance with DOE, NNSA, and local security requirements. At no time must classified information be removed from a Federal facility and taken to any telework location unless that location is authorized for classified storage and processing by NNSA Security. No classified material may be stored on mobile devices at any time except for devices that have been modified and approved by an authorized official. Inadvertent classified leakage to a personal mobile device that cannot be remediated by approved sanitation processes may result in destruction of the personal device without compensation to the owner. All devices that access DOE/NNSA network resources and store Departmental records or data may be subject to record retrieval for business purposes. It may be necessary for NNSA to collect the devices in 12 NNSA SD-314.1 5-15-17 support of record retrieval if records have not been captured in another way. Work Schedules. Employees may be on any type of work schedule (including an alternate work schedule) while teleworking, with supervisory approval. Employees will generally work the same schedule at the telework site as at the regular worksite; however, supervisors have the authority, within the confines of

BOP-02.06, NNSA Leave Administration and Hours of Duty, (and any program/field office hours of duty requirements) to adjust an employee’s tour of duty (e.g., because telework eliminates commute time, employees may be allowed to begin and end the workday earlier when teleworking than days on which they commute to the office). Pay/Leave Administration. The same rules on pay, leave, overtime, and premium pay which apply to employees who report to their regular worksites apply to employees who telework. Documenting Telework in Automated Time Attendance and Production System (ATAAPS). NNSA must provide reports on employee telework participation to OPM, as required or on an ad hoc basis. All time worked, including time teleworking, within the employee’s 80-hour pay period will be recorded in ATAAPS. Appendix 1 provides instructions for Time and Attendance Reporting for telework. Official Duty Station. Employees’ pay is based on the location of their official duty station (worksite). NNSA must determine and designate the official worksite for an employee covered by a telework agreement on a case-by-case basis. The official worksite for an employee covered by a telework agreement is the location where the employee would normally work absent a telework agreement, if the employee is scheduled to report to that worksite at least twice each pay period (two days per pay period) on a regular and recurring basis. The official worksite for an employee covered by a telework agreement who is not scheduled to report at least twice each pay period (two days per pay period) on a regular and recurring basis to the official worksite, or whose work location varies on a recurring basis, must be determined based on the OPM Fact Sheet: Official Worksite for Location-Based Pay Purposes and Telework.gov/Official Worksite. A change in official worksite requires the processing of a personnel action and may require a change in adjusted pay due to applicable locality rates. http://www.opm.gov/policy-data-oversight/pay-leave/pay-administration/fact-sheets/official-worksite-for-location-based-pay-purposes/ http://www.opm.gov/policy-data-oversight/pay-leave/pay-administration/fact-sheets/official-worksite-for-location-based-pay-purposes/ https://www.telework.gov/guidance-legislation/telework-guidance/official-worksite/ NNSA SD-314.1 13 5-15-17 The Head of the NNSA Element approves telework arrangements outside of the official duty station or local commuting area. The supervisor must confer with the NNSA Telework Coordinator to ensure policy compliance. When a duty station change occurs while on an approved telework agreement, a new telework request must be submitted. Commute Time. Employees who are teleworking are eliminating their normal home-to-work commute time, which is not creditable as part of the employees’ hours of duty. Travel time will be considered part of an employee’s hours of duty in certain situations, including when: The employee starts the workday at the telework site then is required or approved to go to the office or another site to conduct NNSA business. The employee starts the workday at the official worksite, an early dismissal is announced, and the employee travels to the alternative worksite and continues working. If the employee leaves the office and does not continue to perform NNSA business, the commute time is not creditable as part of the hours of duty. This would be normal work-to-

home commute time. Emergency, Closure, or Dismissal. During an emergency, closure, or dismissal, all Telework Ready Employees are expected to telework, unless there is an appropriate reason for excusing those employees who would otherwise telework (see Q&A e. in the Work Schedule section of the DOE Desk Reference on DOE-Flex for examples of appropriate reasons). Employees must be prepared to telework the entire workday (regardless of any delayed office arrival time) or take unscheduled leave, i.e., earned annual leave, compensatory time-off, credit hours, sick leave, or LWOP, as appropriate, or a combination of telework and leave, for the entire workday. When an early dismissal is announced, and the employee travels from the worksite to the alternative worksite and continues working, the travel time will be considered part of an employee’s hours of duty. If the employee leaves the office and does not continue to perform NNSA business, the commute time is not creditable as part of the hours of duty. This would be normal work-to-home commute time. Further information on emergency, closure, and dismissal procedures may be found in the DOE Desk Reference on DOE-Flex and OPM's Washington, DC, Area Dismissal and Closure Procedures (NNSA will use this dismissal and closure procedure guidance enterprise-wide for http://energy.gov/sites/prod/files/Desk%20Reference%20on%20DOE-Telework_0.pdf http://energy.gov/sites/prod/files/Desk%20Reference%20on%20DOE-Telework_0.pdf http://www.opm.gov/policy-data-oversight/pay-leave/reference-materials/handbooks/dcdismissal.pdf http://www.opm.gov/policy-data-oversight/pay-leave/reference-materials/handbooks/dcdismissal.pdf 14 NNSA SD-314.1 5-15-17 areas both within and outside the Washington, DC, metro area when an office is facing a dismissal or closure situation). Continuity of Operations Plan (COOP). The use of telework will be incorporated into the agency’s COOP in order to support continuity of operations for both essential and nonessential functions. In the event of an emergency or unexpected event resulting in activation of the COOP, the COOP supersedes the NNSA Telework Plan. Employees designated as emergency employees are expected to report to the designated work location or telework during COOP. There may be circumstances in which an employee who does not have a written telework agreement in place may, nevertheless, be required to telework during a COOP activation. The authority to require an employee to telework in this instance must supersede the requirements of the NNSA telework policy. Emergency employees must follow related administrative or facility closure procedures as directed by NNSA’s management, NNSA’s COOP Coordinator, or the DOE/NNSA COOP Office rather than the NNSA Telework Plan when the COOP is activated. Grievance Procedures. An employee may file a grievance under DOE Order 342.1, Grievance Policy and Procedures when a telework application is disapproved or a current telework agreement is terminated. Employees should contact their Employee Management Relations Specialist for further information on grievance procedures. Telework Forms. All employees must use the applicable NNSA Telework forms attached to this policy and located online on the OneHR site and the Telework page on the NNSA Intranet Portal. Records Management. All telework documentation must be maintained by the NNSA Telework Coordinator. Documents must be maintained for one year after

the end of the employee's participation in the program. 7. RESPONSIBILITIES. Administrator: Oversees and approves NNSA telework policies and implementation plan. Makes final determination on which organizations or groups of positions are eligible for participation in teleworking arrangements. Approves the establishment of NNSA telework centers. Approves actions required to eliminate or mitigate any systemic barriers to implementing NNSA’s telework plan. https://www.directives.doe.gov/directives-documents/300-series/0342.1-BOrder https://www.directives.doe.gov/directives-documents/300-series/0342.1-BOrder https://nnsaportal.energy.gov/intranet/na-mb/na-mb-10/flexiplace/SitePages/Home.aspx NNSA SD-314.1 15 5-15-17 Associate Administrator for Management and Budget: Recommends approval of all telework policies and implementation plans, including the recommendation of which organizations or groups of positions should be eligible for participating in telework arrangements. Recommends approval of actions required to eliminate or mitigate any systemic barriers to implementing NNSA’s telework plan. Head of NNSA Element (includes Field Office Manager): Approves telework arrangements outside of the official duty station or local commuting area, when a change to the employee’s official duty station is required. Designates Local Telework Point of Contact (optional). Director, Human Resources (HR): Manages and oversees the implementation of NNSA’s telework plan. Reviews and recommends approval of: (a) Establishment of, or changes to telework policies and implementation plan(s); (b) Requests for establishment of any Telework Centers; and (c) Actions for the elimination or mitigation of systemic barriers to implementing NNSA’s telework plan. Provides data on program participation to the Deputy Associate Administrator Management and DOE as requested. NNSA Telework Coordinator (HR, Employee Management Relations Division): Provides guidance to managers, supervisors, and employees on telework policies, changes to official duty station, and implementation plan(s). Manages the administration of telework policies and implementation plan(s), including the maintenance of all telework agreements and records. Conducts compliance/administrative reviews of telework package (including medical documentation) prior to the employee starting to telework to ensure policy compliance. Confirms training and information is provided to all participating supervisors and employees as needed or requested. 16 NNSA SD-314.1 5-15-17 Monitors and identifies barriers to implementing NNSA’s telework plan and recommends actions for the elimination or mitigation of those barriers. Collects data on program participation for submission to the Director, HR; the Deputy Associate Administrator Management; and DOE as requested. Second Level Supervisor: Concurs on disapproval, suspension, or termination of telework applications or agreements. Supervisor: Completes telework training prior to supervising employees who telework or are entering into a telework agreement. Provides certificate of training to Telework Coordinator. Determines whether an employee is eligible for participation in a telework arrangement or meets one of the exclusions. Reviews and approves or disapproves telework applications (including medical documentation, as applicable). Coordinates with the NNSA Telework Coordinator to ensure policy

compliance as necessary, i.e., medical telework, change in duty station, change in locality pay, etc. Enters into a telework agreement with employees approved to telework. Approves employee requests to work under their situational telework agreement (approves each situational request). Reviews telework agreements at the end of the fiscal year, and recertifies them as applicable. Initiates the termination/suspension of a telework agreement in accordance with the requirements of this SD (e.g., when employee’s performance falls below FME). Treats teleworkers the same as non-teleworkers with regard to performance management, work assignments, awards and recognition, development opportunities, promotions, etc. Complies with the requirements and responsibilities in DOE Order 314.1 and NNSA Telework policy documents. Local Telework Point of Contact (Optional Duty): Coordinates with field/program office management and employees and the NNSA Telework NNSA SD-314.1 17 5-15-17 Coordinator to ensure completion of telework packages and other telework requirements as applicable. Employee: Completes, signs, and submits a telework application/package if interested in participating in telework. Completes telework training prior to entering into a telework agreement. Provides certificate of training to Telework Coordinator. Enters into a telework agreement with supervisor after obtaining approval to telework and completing training. Complies with the requirements and responsibilities in DOE Order 314.1 and NNSA policy documents. 8. REFERENCES. Presidential Memorandum - Enhancing Workplace Flexibilities and Work-Life Program, issued 6-23-14 31 U.S.C. 1348, note (from Public Law 104-52, § 620) Public Law No. 111-292, Telework Enhancement Act of 2010 Public Law 106-346, § 359, requires that all Executive agencies establish telework policies 10 CFR 1017, Subpart E, Identification and Protection of Unclassified Controlled Nuclear Information 45 CFR 164, Subpart E, Privacy of Individually Identifiable Health Information Telework.gov The Office of Personnel Management’s (OPM’s) Guide to Telework in the Federal Government, dated April 2011 OPM’s Washington, DC, Area Dismissal and Closure Procedures, dated December 2015 DOE O 203.1, Limited Use of Government Office Equipment Including Information Technology, dated 4-23-09 DOE O 203.2, Mobile Technology Management, dated 5-15-14 DOE O 205.1B, Dept. of Energy Cyber Security Program, dated 5-16-11 https://www.whitehouse.gov/the-press-office/2014/06/23/presidential-memorandum-enhancing-workplace-flexibilities-and-work-life- https://www.whitehouse.gov/the-press-office/2014/06/23/presidential-memorandum-enhancing-workplace-flexibilities-and-work-life- https://www.congress.gov/bill/111th-congress/house-bill/1722?search=%7B%22search%22%3A%5B%22telework+enhancement%22%5D%7D https://www.congress.gov/bill/111th-congress/house-bill/1722?search=%7B%22search%22%3A%5B%22telework+enhancement%22%5D%7D https://www.congress.gov/106/plaws/publ346/PLAW-106publ346.pdf http://www.ecfr.gov/cgi-bin/text-idx?tpl=/ecfrbrowse/Title10/10cfr1017_main_02.tpl http://www.ecfr.gov/cgi-bin/text-idx?SID=3ebe2fa41702a9903cccae0d5482dad6&mc=true&node=sp45.1.164.e&rgn=div6 https://www.telework.gov/ https://www.telework.gov/guidance-legislation/telework-guidance/telework-guide/guide-to-telework-in-the-federal-government.pdf https://www.telework.gov/guidance-legislation/telework-guidance/telework-guide/guide-to-telework-in-the-federal-government.pdf https://www.opm.gov/oca/compmemo/dismissal.pdf https://www.directives.doe.gov/directives-documents/200-series/0203.1-BOrder https://www.directives.doe.gov/directives-documents/200-series/0203.1-BOrder https://www.directives.doe.gov/directives-documents/200-series/0203.2-BOrder http://energy.gov/cio/downloads/order-doe-o-2051b

18 I. m. n. o. p. q. r. DOE 0 243.IB, Records Management Program, dated 3-11-13 DOE 0 314.1, DOE-Flex: DOE's TeleworkProgram. dated 2-11-13 and all references listed therein DOE 0 322.1 C Pay and Leave Administration and Hours of Duty, dated 5-10-12 DOE's Desk Reference on DOE-Flex, dated July 2011 DOE Handbook on Overtime, dated February 2004 NNSA SD 243.1, Records Management Program, dated 3-21-16 BOP-002.06, NNSA Leave Administration and Hours of Duty, dated 3-13-09 9. DEFINITIONS. See Appendix 1. 10. CONTACT. Human Resources, Employee Management Relations Division, NA-MB-17, 505-845-4850 BY ORDER OF THE ADMINISTRATOR: ~I~~ Administrator Appendixes: 1. Definitions 2. Time and Attendance Reporting for Telework 3. Submission ofTelework Forms/Package 4. Telework Application Process Flow Chait 5. Employee Telework Eligibility Notice/ Application 6. NNSA Telework Self-Certification Safety Checklist 7. TeleworkAgreement 8. Employee Telework Recertification Form 9. Employee Telework Suspension or Termination https://www.directives.doe.gov/directives-documents/200-series/0243.1-BOrder-b-admchg1 https://www.directives.doe.gov/directives/0314.1-BOrder/view https://www.directives.doe.gov/directives-documents/300-series/0322.1-BOrder-c-admchg1 http://www.energy.gov/hc/downloads/desk-reference-doe-flex http://energy.gov/hc/downloads/doe-handbook-overtime https://nnsaportal.energy.gov/intranet/na-mb/Active%20Policies/SD%20243.1%20AC1.pdf https://nnsaportal.energy.gov/intranet/na-mb/Active%20Policies/SD%20243.1%20AC1.pdf https://nnsaportal.energy.gov/intranet/na-mb/Active%20Policies/BOP-002.06%20Change%201%20Leave%20Administartion%20and%20Hours%20of%20Duty.pdf NNSA SD-314.1 Appendix 1 5-15-17 AP1-1 APPENDIX 1: DEFINITIONS Emergency Employee: Employee who must report for work or telework in emergency situations, e.g., severe weather conditions, air pollution, power failures, interruption of public transportation, and other situations in which significant numbers of employees are prevented from reporting for work or which require agencies to close all or part of their activities. This includes employees performing work involving the safety of human life or the protection of property. Head of NNSA Element: The most senior level position in an NNSA element. These positions are currently Deputy Administrators, Associate Administrators, Field Office Managers, and the General Counsel. Local Telework Point of Contact: Individual designated by local office to coordinate with field/program office management, employees, and the NNSA Telework Coordinator. (This is an optional duty. Offices are not required to designate this duty.) NNSA Telework Coordinator: Located in HR, Employee Management Relations Division. Manages the administration of the telework program for the enterprise. Non-emergency employee: An employee who has not been designated as an emergency employee. Reasonable Accommodation: Any modification or adjustment to a job or the work environment that will enable a qualified applicant or employee with a disability to participate in the application process or to perform essential job functions. Telework Ready: A Telework Ready employee is an employee who has a signed telework agreement in place for a routine, situational, or medical telework arrangement. Unscheduled Leave: Leave that has not been scheduled (requested/approved) in advance,

but is requested at the time of an emergency, delay, or closure in lieu of teleworking or reporting to the office. Unscheduled Telework: Telework that has not been scheduled or approved in advance, but is requested or required due to personal or business-related reasons (such as personal or non-personal emergencies or site closures). THIS PAGE INTENTIONALLY LEFT BLANK NNSA SD-314.1 Appendix 2 5-15-17 AP2-1 APPENDIX 2: TIME AND ATTENDANCE REPORTING FOR TELEWORK NNSA must submit reports on employee telework participation to OPM, as required or on an ad hoc basis. Therefore, all time worked, including teleworking, within the employee’s 80-hour pay period, will be recorded in the DOE Automated Time and Attendance Production System (ATAAPS). Normal rules and procedures apply for authorizing, approving, earning, and using leave, overtime, compensatory time, or credit hours in accordance with BOP-002.06, NNSA Leave Administration and Hours of Duty, DOE O 322.1C, Pay and Leave Administration and Hours of Duty, and the DOE Handbook on Overtime. The employee’s time and attendance must be certified by the Certifying Official to account for all telework hours included in the work schedule. Time and attendance will be reported as though the employee were at the duty station and the applicable ATAAPS reason codes for telework must be added (TW=Routine (Listed as Regular in ATAAPS), TS=Situational, TM=Medical). For Routine, Situational, and Medical telework, use the following instructions to code telework in ATAAPS via Employee Self Service (ESS): • Select the appropriate pay period. • Select the InsertRow checkbox to insert a new row for the hours teleworked. • Enter your time and save. • Select the NtDiff/Haz/Oth checkbox (on the lower row). • Click ADD under the Hz/Oth row to open a drop-down list. • Scroll down the list and select the appropriate telework code. • Select the Reason box and save your timesheet. Instructions are also available at http://chris.doe.gov/payroll/RecordingFlexiplace.PDF. http://chris.doe.gov/payroll/RecordingFlexiplace.PDF THIS PAGE INTENTIONALLY LEFT BLANK NNSA SD-314.1 Appendix 3 5-15-17 AP3-1 APPENDIX 3: SUBMISSION OF TELEWORK FORMS/PACKAGE NNSA Telework Forms Routine & Situational Telework Package Situational Telework Package Medical & Situational Telework Package NNSA Telework Eligibility Notice/Application ☒ ☒ ☒ NNSA Employee Telework Agreement ☒ ☒ ☒ OPM Employee Telework Training Certificate ☒ ☒ ☒ OPM Supervisory Telework Training Certificate ☒ ☒ ☒ NNSA Telework Self-Certification Safety Checklist ☒ ☒ ☒ Medical Documentation for a Medical Arrangement NA NA ☒ NNSA Telework Agreement Review Annually Annually Annually NNSA Telework Agreement Recertification When Making a Change to the Current Telework Agreement When Making a Change to the Current Telework Agreement When Making a Change to the Current Telework Agreement NNSA Telework Suspension/Termination When Appropriate When Appropriate When Appropriate Distribution NNSA Telework Coordinator (Original - File Maintained by NNSA Telework Coordinator) Y Y Y Employee (Copy) Y Y Y Supervisor (Copy) Y Y Y Time Keeper (Copy) As Appropriate As Appropriate As Appropriate THIS PAGE INTENTIONALLY LEFT BLANK NNSA SD-314.1 Appendix 4 5-15-17 AP4-1 APPENDIX 4: TELEWORK APPLICATION PROCESS FLOW CHART Are you eligible to telework?

The NNSA Telework Program is voluntary. To participate, NNSA employees must complete the required employee telework training and NNSA Employee Telework Package. Have you completed the required employee telework training, NNSA Employee Telework Package, and submitted it to your supervisor? No Yes Yes Your supervisor/Approving Official has signed/approved your NNSA Employee Telework Package. Have you been designated as an emergency employee? You have been approved to telework and designated as a non-emergency employee. During an emergency situation, non-emergency employees are expected to telework in accordance with their NNSA Employee Telework Package, unless there is an appropriate reason for excusing employees who would otherwise telework. Supervisors should provide the NNSA Telework Coordinator with a copy of the complete signed package. You have been approved to telework and designated as an emergency employee. During an emergency situation, emergency employees must report for work or telework, in accordance with NNSA policy requirements and as specified in the telework package. Yes You are ineligible to telework and will not be required to telework in emergency situations. Supervisors are to provide a copy of the signed NNSA Telework Eligibility Notice/Application to the NNSA Telework Coordinator. Supervisors should complete the NNSA Telework Eligibility Notice/Application and discuss telework eligibility or ineligibility with their respective employees. No I am not sure No Go Back Go Back THIS PAGE INTENTIONALLY LEFT BLANK NNSA SD-314.1 Appendix 5 5-15-17 AP5-1 APPENDIX 5: EMPLOYEE TELEWORK ELIGIBILITY NOTICE/APPLICATION This form is used to submit application for telework and to determine if employee is telework eligible. Print or complete electronically. (Use the Tab Key to move from Field to Field/Double click on each box to fill, click on “Checked”, then click OK) SECTION 1 SECTION TO BE COMPLETED BY EMPLOYEE Employee’s Information Supervisor’s Information Name: Name: Title/Series: Title/ Organization: Phone Number: Phone Number: SECTION 2 ELIGIBILITY NOTICE ACKNOWLEDGEMENT AND REQUEST TO TELEWORK SECTION TO BE COMPLETED AND SIGNED BY EMPLOYEE I am requesting to telework. I acknowledge that I reviewed DOE Order 314.1, DOE-FLEX: DOE’S Telework Program, NNSA’s Supplemental Directive, 314.1, NNSA Telework Plan, and DOE’s Desk Reference on DOE-Flex, and understand the policies, procedures and requirements. Employee’s Signature: _______________________________________ Date: _____________ SECTION 3 TELEWORK ELIGIBILITY NOTIFICATION SECTION TO BE COMPLETED BY SUPERVISOR a. Is this position eligible for telework? Yes No https://nnsaportal.energy.gov/intranet/na-mb/na-mb-10/flexiplace/SitePages/Home.aspx Appendix 5 NNSA SD-314.1 AP5-2 5-15-17 b. Is this employee eligible to telework? (If no, reference the Criteria for Telework Ineligibility Worksheet attached, for specific reason, and check the letter box below which corresponds to the reason on the worksheet.) a. b. c. d. e. f. g. h. i. j. Yes No c. Indicate the types of telework arrangement(s) that may be approved. (Medical documentation must be provided to support a medical arrangement.) Please mark one box only, as appropriate. Routine & Situational Situational Medical & Situational d. Employee is eligible to telework under the following situations:

COOP Emergency Non-emergency Personal Emergency Personal Non-Emergency SECTION 4 ACTION ON TELEWORK ELIGIBILITY APPLICATION SECTION TO BE SIGNED BY SUPERVISOR AND Head of Element (when appropriate) a. Supervisor: Approved Not Approved If not approved, provide the reason(s), including any alternate recommendation(s): Supervisor’s Signature: ___________________________________Date: ____________ b. Change in Duty Station Required: Yes No Head of Element/Field Office Manager’s Signature: _______________ _Date: ________ c. If yes to b., approved SF-52 is attached: Yes No Note: Management action, i.e., to either approve or not approve a telework request, should occur regardless of the band/grade level of the employee submitting the request. All requests should be acted upon within 10 workdays of submission and in no case not later than 20 calendar days of the date of submission of a complete, actionable package. Notification may be accomplished by electronic mail by attaching this signed form. If the application is not approved, the employee may file a grievance under the DOE O 342.1, Grievance Policy and Procedures. SECTION 5 DISTRIBUTION Supervisor Employee NNSA Telework Coordinator SECTION 6 PRIVACY ACT STATEMENT The Telework Enhancement Act of 2010 (Public Law 111-292), Section 6120 of Title 5 to the United States Code, and Executive Memorandum of July 11, 1994 (59 FR 36017) authorizes collection of this information. Providing information and signing this application is voluntary, but failure to sign it will preclude the authorization for the employee to telework. The primary use of the information contained in this agreement is by applicable management officials and supporting administrative staffs, payroll and accounting staffs, human resource staffs, and NNSA Telework Coordinator to approve and record the NNSA Employee Telework Agreement. There are no additional uses that may be made of the information collected in the agreement unless otherwise allowed for in applicable regulations. The official copy of this agreement, which is a category of record included in the OPM/GOVT-1 General Personnel Records system, is maintained by the NNSA Telework Coordinator. mailto:lynn.ashby@nnsa.doe.gov mailto:lynn.ashby@nnsa.doe.gov NNSA SD-314.1 Appendix 5 5-15-17 AP5-3 CRITERIA FOR TELEWORK INELIGIBILITY WORKSHEET If the answer is YES to any of the items below, the employee is Telework Ineligible, unless further clarified. Please check the appropriate box in Section 3.b. above that corresponds with any YES selections below. Employees designated by their supervisors to be ineligible to telework WILL NOT be required to telework during emergency/closure situations. a. The employee has not been in the organization long enough to know his/her duties and/or organizational relationships sufficiently well enough to perform independently in a telework environment (Employee may reapply at a later date). Yes No b. The employee’s position involves only work that is performed at off-site locations and/or while traveling between worksites, such as the transport of nuclear materials. Yes No c. The employee’s capability to access the network does not meet the network security requirements and no other work of equal or higher priority that is acceptable to the supervisor can be performed at an alternative worksite. Yes No

d. The employee’s position involves work that is normally restricted to be performed on-site every day; e.g., work involving the handling of classified information or frequent face-to-face contact. [However, if an employee is approved to perform work off-site during emergency/closure situations, then the employee must be on a situational telework agreement that is limited to emergency/closure situations in order to perform the work and must be indicated in Section 3.d. (i.e. COOP and Emergency)], as applicable. Yes No e. The employee is designated as a member of the NNSA Emergency Response Group who must be on site during emergency situations in order to perform his/her duties. If yes, the employee is Telework Ineligible during emergencies but may be eligible to telework during non-emergency situations as indicated in Section 3.d. (i.e. Non-emergency, Personal Emergency and/or Personal Non- Emergency). Yes No f. The employee’s performance has been evaluated at below the Fully Meets Expectations (FME) Level. (If yes, the employee may only be eligible to telework under an emergency/closure situation if the employee is showing improvement while subject to a PCM, PAP, or PIP.) Yes No g. The employee has previously been removed from telework for lack of reliability, e.g., loafing, unresponsive, missing in action, wasting time, other computer misuse, etc. Yes No h. The employee has been officially disciplined during the calendar year for being absent without permission for more than 5 days. Yes No Appendix 5 NNSA SD-314.1 AP5-4 5-15-17 i. The employee has been officially disciplined for violation of subpart G of the Standards of Ethical Conduct for viewing, downloading, or exchanging inappropriate material (i.e. exchanging pornography, including child pornography,) on a Federal Government computer or while performing official Federal Government duties. Yes No j. Other (Specify Reason) ________________________________________________________ Yes No TELEWORK SUITABILITY WORKSHEET a. The employee’s performance standards are in place and contain suitable work assignments for the type of telework arrangement(s) specified in Section 3c. and 3d.  Thinking and writing: reviewing, editing, scheduling, planning, and policy development; writing various strategic plans or reports; researching; investigating; and/or analysis, etc.  Telephone intensive tasks: customer service, setting up a conference, obtaining information, and following up on participants in a study, etc.  Computer oriented tasks: programming, data entry, word processing, or on- line training, etc. Yes No NNSA SD-314.1 Appendix 6 5-15-17 AP6-1 APPENDIX 6: NNSA TELEWORK SELF-CERTIFICATION SAFETY CHECKLIST Print or complete electronically and submit this form with the telework package. (Use the Tab Key to move from Field to Field/Double click on each box to fill, click on “Checked”, then click OK) FORM TO BE COMPLETED BY EMPLOYEE WHEN A HOME WILL BE THE TELEWORK SITE The purpose of this form is to ensure that the terms of the telework agreement are fulfilled. The employee, if declaring that the telework site will be a home, agrees to maintain it in a reasonably safe condition, keeping it hazard-free and normally free from distractions. If the employee answers “no” to any of the questions below, the supervisor and the employee should discuss the issue so that both the employee and the supervisor understand the condition of the worksite. This checklist will be made available to the appropriate safety and workers’ compensation officials if the employee is injured at home while performing work and files a claim for compensation under the Federal Employee Compensation Act.

Employee’s Name: Supervisor’s Name: Part I - Worksite Environment Yes No 1. Are temperature, noise, ventilation, and lighting levels adequate for maintaining your normal level of job performance? 2. Are all stairs with four or more steps equipped with handrails? 3. Is electrical system adequate for office equipment? 4. Is all electrical equipment free of recognized hazards that would cause physical harm (frayed wires, bare conductors, loose wires, flexible wires running through walls, exposed wires to the ceiling)? 5. Are aisles, doorways, and corners free of obstructions to permit visibility and movement? 6. Are file cabinets and storage closets not top-heavy and arranged so drawers and doors do not open into walkways? 7. Are chairs free of any loose casters (wheels) and are the rungs and legs of the chairs sturdy? 8. Are the phone lines, electrical cords, and extension wires secured under a desk or alongside a baseboard and away from heat sources? 9. Is the office space neat, clean, and free of combustibles? 10. Is there a working smoke detector in the workspace area? 11. Is there a home multi-use fire extinguisher, which you know how to use, readily available? 12. Are floor surfaces clean, dry, level, and free of worn or frayed seams? https://nnsaportal.energy.gov/intranet/na-mb/na-mb-10/flexiplace/SitePages/Home.aspx Appendix 6 NNSA SD-314.1 AP6-2 5-15-17 13. Are carpets well secured to the floor and free of frayed or worn seams? 14. Is there enough light for reading? Part II – Workstation Yes No 15. Is your chair adjustable? 16. Is your back adequately supported by a backrest? 17. Are your feet on the floor or fully supported by a footrest? 18. Do you have enough leg room at your desk? 19. Are your wrists in a comfortable position when keying? 20. When keying, are your forearms close to parallel with the floor? 21. Is there space to rest the arms while not keying? 22. Is the top of the monitor eye level? 23. Is it easy to read the text on your monitor? 24. Is the monitor free from noticeable glare? Employee’s Comments: Employee’s Signature: _________________________________________________ Date: ___________ Supervisor’s Comments: Supervisor’s Signature: _________________________________________________ Date: __________ NNSA SD-314.1 Appendix 7 5-15-17 AP7-1 APPENDIX 7: TELEWORK AGREEMENT Print or complete electronically and submit this form to establish a telework agreement. (Use the Tab Key to move from Field to Field/Double click on each box to fill, click on “Checked”, then click OK) SECTION 1 SECTION TO BE COMPLETED BY EMPLOYEE Employee’s Information Supervisor’s Information Name: Name: Title: Title: Work Number: Work Number: Organization: Date of Request: Official Worksite: Address: Telework Site: Home Address: Telecenter: Satellite Office/Other: Telework Site Phone #: Cell Phone #: a. This NNSA Telework Agreement is between ________________________________ (Employee’s Name) and the NNSA. The agreement specifies the terms and conditions under which the employee will work at the telework site specified above. This agreement does not create an entitlement, but recognizes that telework is an additional method the NNSA uses to strategically accomplish its goals and mission. b. Specify the type of Telework Arrangement(s). Please mark one box only, as appropriate. Routine & Situational Situational Medical & Situational

c. I have reviewed, signed, and attached my current NNSA Employee Telework Eligibility Notice/Application. Yes No d. I have reviewed the information and material on the www.telework.gov website, including Telework Basics for Employees. Yes No e. I have reviewed NNSA’s Supplemental Directive, SD 314.1, NNSA Telework Plan, DOE Desk Reference on DOE-Flex, and the attached Terms and Conditions for Telework Ready Employees; discussed the telework requirements with my supervisor; and understand the policies and procedures specified. Yes No https://nnsaportal.energy.gov/intranet/na-mb/na-mb-10/flexiplace/SitePages/Home.aspx http://www.telework.gov/ https://www.telework.gov/federal-community/telework-employees/telework-basics/ Appendix 7 NNSA SD-314.1 AP7-2 5-15-17 f. I have completed the required OPM Employee Telework Training; and attached the OPM Employee Telework Training Certificate. Yes No g. When the telework worksite will be a home, I have completed and attached the NNSA Telework Self-Certification Safety Checklist (Appendix 2) to my application. Yes No h. For a Medical Arrangement, supporting medical documentation is attached. If not, explain. (Medical documentation must be provided to support a medical telework arrangement at the time of a request; and, should not begin without required medical documentation.) Yes No i. In the chart below, provide your weekly schedule, specifying the day(s), hours of duty (consistent with approved tour of duty unless change is approved in advance)*, and duty station. For each respective column under the Duty Station section, use an X to indicate the day(s) you will be at the official duty station or at the telework site for Routine or Medical telework arrangements, as appropriate. For Situational telework agreements, complete only the Hours of Duty column, as appropriate. *Maxiflex and Gliding schedules may be adjusting accordingly. Pay Period Work Week Day Hours of Duty From To Duty Station Official Telework Site Week 1 Monday Tuesday Wednesday Thursday Friday Week 2 Monday Tuesday Wednesday Thursday Friday j. In the box below, please check your current approved work schedule arrangement (if type of work schedule is changed, an amendment should be provided). Basic Tour Compressed Work Schedules Flexible Work Schedules 8-Hour/Day Five- day Workweek (M-F) 5/4/9 Four-Day Workweek Flexitour Gliding Schedule Maxiflex http://www.telework.gov/tools_and_resources/training/employees/index.aspx NNSA SD-314.1 Appendix 7 5-15-17 AP7-3 SECTION 2 EMERGENCY RESPONSE AND NONEMERGENCY TERMS OF AGREEMENT SECTION TO BE COMPLETED BY SUPERVISOR a. Emergency Designation: (Please check all boxes that apply, as appropriate.) COOP Emergency Responder Emergency Personnel Non-Emergency Personnel b. The employee is designated as an emergency employee who must report for work in emergency situations, e.g., severe weather conditions, air pollution, power failures, interruption of public transportation, and other situations in which significant numbers of employees are prevented from reporting for work or which require agencies to close all or part of their activities. Yes No c. The employee is designated as a COOP Emergency Responder who must report to the designated work location and/or telework during COOP-related administrative or facility closures as directed by NNSA’s management, COOP Coordinator and/or NNSA’s COOP Office.

Yes No d. The employee understands that he/she is hereby notified that as a telework ready employee, he/she may be required/directed to telework during COOP activation, emergencies, area closures and dismissals etc. in accordance with NNSA policy and guidance provided during any emergency/operating status announcement. Yes No SECTION 3 SECTION TO BE COMPLETED BY THE SUPERVISOR a. I have discussed the attached NNSA Employee Telework Eligibility Notice/Application (Appendix 1) with employee. The notice/application are attached. If no, then these forms must be prepared and submitted with this agreement. Yes No b. I have reviewed the NNSA Telework Agreement Self-Certification Safety Checklist (Appendix 2); discussed the telework requirements with the employee; and understand the policies and procedures of the NNSA Telework Program. Yes No c. I have completed the required OPM Telework 101 for Managers Training; and attached the OPM Manager Telework Training Certificate. Yes No d. I have approved employee’s telework tour of duty as described in section 1.i. above Yes No http://www.telework.gov/tools_and_resources/training/managers/index.aspx Appendix 7 NNSA SD-314.1 AP7-4 5-15-17 SECTION 4 SECTION TO BE COMPLETED BY EMPLOYEE AND SUPERVISOR a. Will the employee’s remote access be compatible with NNSA’s/DOECOE’s or other NNSA/DOE-approved IT network? If no, what needs to be done to make it compatible? _____________ Yes No b. Does the employee have current antivirus and any other needed security application on his/her computer? Yes No c. Are the requested resource(s) available to support the employee to telework? If no, what is recommended? _______________________________________ Yes No d. The following IT equipment, software, service(s), and/or supplies have been assigned to the employee: None RSA Token Laptop Computer Phone Card Air Card Cell phone Printer Card Reader Supplies____________ Acknowledgement: I understand that any equipment/resources assigned to me, are for use to perform official duties. I assume full responsibility for proper use and care of these items and understand that all items must be returned to the agency upon completion, suspension, or termination of the telework agreement. Employee’s Signature: _________________________________________ Date:____________ Supervisor’s Signature: _________________________________________ Date:____________ SECTION 5 ACTION ON AGREEMENT SECTION TO BE COMPLETED BY EMPLOYEE AND SUPERVISOR a. This agreement is effective ______________________ (Start/Effective Date) and will continue: Indefinitely for a Routine/Situational arrangement, subject to review at least annually during the annual performance evaluation, and recertified annually if there is a change, using the NNSA Employee Telework Recertification Form (Appendix 4). Indefinitely for a Situational arrangement, subject to review at least annually during the annual performance evaluation, and recertified annually if there is a change, using the NNSA Employee Telework Recertification Form (Appendix 4). Until ______________ (End Date) or an extension ______________ (1st Extension End Date) for a Medical/Situational arrangement contingent upon acceptable medical documentation. The duration may be shortened or extended depending on the medical situation, if medically necessary, and agreed to by the employee and supervisor. NNSA SD-314.1 Appendix 7 5-15-17 AP7-5

Until ______________ (2nd Extension End Date) for a medical arrangement contingent upon acceptable medical documentation. Note: A new telework agreement must be signed and approved when the employee is placed under a new supervisor. b. Certification: I hereby certify that I have read, understand and agree to the attached Terms and Conditions for Telework Ready Employees that apply to this NNSA Telework Agreement. I also understand that the information is accurate as of this date, but that applicable policies and guidelines may change or may be added without amending this agreement accordingly. I understand that I will be informed of these changes. In the event of such changes, I understand that this agreement will be subject to the new policies and guidelines approved by management. a. Employee’s Signature: _________________________________________ Date: ___________ b. Supervisor’s Signature: ________________________________________ Date: ____________ SECTION 6 ATTACHMENTS SECTION TO BE COMPLETED BY EMPLOYEE AND SUPERVISOR NNSA Employee Telework Eligibility Notice/Application NNSA Telework Self-Certification Safety Checklist Employee Telework Training Certificate Manager and Supervisor Telework Training Certificates SF-52 Form, when necessary Medical Documentation for a Medical Telework Arrangement, when necessary SECTION 7 SIGNED TELEWORK AGREEMENT DISTRIBUTION Supervisor Employee NNSA Telework Coordinator Timekeeper* *Only the signed telework agreement is distributed to the timekeeper. SECTION 8 PRIVACY ACT STATEMENT The Telework Enhancement Act of 2010 (Public Law 111-292), Section 6120 of Title 5 to the United States Code, and Executive Memorandum of July 11, 1994 (59 FR 36017) authorizes collection of this information. Providing information and signing this application is voluntary, but failure to sign it will preclude the authorization for the employee to telework. The primary use of the information contained in this agreement is by applicable management officials and supporting administrative staffs, payroll and accounting staffs, human resource staffs, and NNSA Telework Coordinator to approve and record the NNSA Employee Telework Agreement. There are no additional uses that may be made of the information collected in the agreement unless otherwise allowed for in applicable regulations. The official copy of this agreement, which is -1 General Personnel Records system, is maintained by the NNSA Telework Coordinator. Furnishing the information on this form, including your home address, is voluntary. mailto:lynn.ashby@nnsa.doe.gov mailto:lynn.ashby@nnsa.doe.gov Appendix 7 NNSA SD-314.1 AP7-6 5-15-17 NNSA TELEWORK AGREEMENT TERMS AND CONDITIONS FOR TELEWORK READY EMPLOYEES SUPERVISOR TELEWORK DISCUSSION WITH EMPLOYEE The supervisor should discuss these terms and conditions with the employee, so he/she understands the policies and procedures of the NNSA Telework Program and understands that he/she will be treated the same at all worksites.

a. Applicable Policy and Guidance. The employee and supervisor agree that all policies and practices that apply to the employee at the employee’s organization to which assigned apply to the employee at the telework site and that the employee is to be treated the same in both situations. In addition, the following polices apply to telework: DOE O 314.1, DOE-Flex: DOE’s Telework Program, or its successor Order; DOE’s Desk Reference on DOE-Flex or its successor; NNSA SD 314.1, NNSA Telework Plan or its successor; Office of Personnel Management’s (OPM’s) Guide to Telework in the Federal Government or its successor; OPM’s Washington, DC Area Dismissal and Closure Procedures or its successor (effective for all NNSA Program Offices/Field Office telework ready employees); and DOE O 206.1, Department of Energy Privacy Program or its successor, which addresses protecting personally identifiable information (PII). The employee is bound by the Standards of Conduct for Employees of the Executive Branch and DOE’s Supplement: Fourteen Principles of Ethical Conduct for Federal Employees while working at the telework site. The employee agrees to abide by all NNSA policies and practices that apply to an NNSA program office and/or field office. b. Telework Duties. Employee will perform those work assignments agreed to with his/her supervisor. The employee should be prepared to discuss the projects, tasks, and assignments to be worked on while teleworking and provide feedback, as necessary. c. Performance. The employee and his/her supervisors understand that the same SPOs apply while on telework as at the employee’s organization’s office and that the employee will be treated the same at all worksites. He/she further understands that if the employee’s supervisor determines that the employee’s performance has dropped below the Fully Meets Expectations (FME) or equivalent Fully Successful level, the employee may only be eligible to telework under a limited situational agreement (e.g., during emergencies or closures) if the employee is showing improvement while subject to a PCM, PAP, OR PIP. d. Communication. Employee will notify his/her supervisor and co-workers via email that he/she is teleworking and provide a phone number for the day. He/she should also advise when taking lunch and will not be available. If the power is out, he/she will notify his/her supervisor as soon as possible of the problem. The employee will forward the office telephone to the telework site or provide a voice-mail greeting message that informs callers how (and when) to contact the employee; and will be accessible (i.e., either responding promptly to management’s attempts to contact him/her or responding within the time frame expected if the employee were at the office) during agreed-upon hours of work. e. Availability. Employee will notify his/her supervisor of any change in availability (e.g., departure for and return from an appointment or a conference call that will tie up the telephone for a while), and of any change in contact information.

https://www.directives.doe.gov/directives/current-directives/314.1-CNotice/view?searchterm=None https://www.directives.doe.gov/directives/current-directives/314.1-CNotice/view?searchterm=None http://humancapital.doe.gov/resources/Desk%20Reference%20on%20DOE-Flex%207-11.pdf http://www.telework.gov/guidance_and_legislation/telework_guide/telework_guide.pdf http://www.telework.gov/guidance_and_legislation/telework_guide/telework_guide.pdf http://www.opm.gov/policy-data-oversight/pay-leave/reference-materials/handbooks/dcdismissal.pdf http://www.opm.gov/policy-data-oversight/pay-leave/reference-materials/handbooks/dcdismissal.pdf https://www.directives.doe.gov/directives/current-directives/206.1-BOrder/view?searchterm=None http://www.usoge.gov/Laws-and-Regulations/Employee-Standards-of-Conduct/Employee-Standards-of-Conduct/ http://humancapital.doe.gov/orientation-15-principles.htm http://humancapital.doe.gov/orientation-15-principles.htm NNSA SD-314.1 Appendix 7 5-15-17 AP7-7 f. Salary and Benefits. Working at a telework site is not a basis for changing the employee's salary or benefits. g. Pay and Travel. Employee’s pay and travel entitlements are based on the employee’s official worksite location and a determination as to whether or not evacuation pay and associated travel expenses are authorized due to an evacuation that affects the employee. h. Overtime/Credit Hours. The provisions governing premium pay have been explained and the employee understands that NNSA policy requires that he/she obtain his/her supervisor’s approval in writing before the employee works overtime. This requirement also applies when the employee is teleworking. The employee is not permitted to work overtime unless it is authorized and approved in advance by his/her supervisor. If available, credit hours may be earned while teleworking, with supervisory approval and in accordance with NNSA policies and procedures. i. Work/Telework Schedule. The employee’s daily hours of duty will generally be the same as at the official worksite unless a deviation is approved or directed by his/her supervisor. The employee understands that he/she may be required to telework on other days, in addition to their regularly scheduled telework day, or may request unscheduled telework (e.g., during closures or emergencies). The employee further understands that if his/her supervisor determines that a change in the employee’s previously approved telework schedule is necessary due to operational needs; e.g., the supervisor’s or a co-worker’s absence, a face-to-face meeting or conference, examination of materials that cannot be taken from the worksite, or to serve as a witness, the supervisor may direct the employee to be at the organization’s main office or other location on a day or part of a day that the employee would otherwise telework, unless there are extenuating circumstances that would preclude that from happening or result in the employee requesting leave for the day; e.g., a medical appointment that shouldn’t be cancelled. Notice of this direction would be given as far in advance as possible. The employee further understands that he/she has no claim on another day during the current pay period or any other pay period to substitute another day or days on telework unless an alternative day during the pay period is approved; however, the supervisor will make every effort to establish a mutually agreeable adjustment in the employee’s telework schedule. An employee’s official tour of duty must include a 30-minute uncompensated lunch when working 8 hours or more.

For a Routine or Medical telework arrangement, a copy of the employee’s work schedule will be provided to the employee’s timekeeper (when applicable). For a Situational telework arrangement, the number of hours or days spent teleworking will depend on the situation or nature of the assignment. j. Dismissal and Closure Procedures. When changes in the Operating Status of the Federal Government or an issue at a DOE/NNSA facility impact the normal operations of the official worksite, the expectations of the employee to telework will be based upon several factors such as the nature of the employee’s interactions with the worksite affected by the dismissal or closure; the nature and severity of the emergency situation; the duration of the situation; and other circumstances that are common or unique to a given emergency (i.e., childcare, power outages, travel delays, etc.). The employee and supervisor agree that: When “Federal Offices are Closed” or a DOE/NNSA Facility is closed, the employee is expected to telework if he/she has a telework agreement in place. Employees with a telework agreement in place are expected to work the entire day or to the extent possible, unless there is a good reason Appendix 7 NNSA SD-314.1 AP7-8 5-15-17 for excusing an employee who would otherwise telework (see Q&A e. in the Work Schedule section in the DOE Desk Reference on DOE-Flex for examples of appropriate reasons). Employees on pre-approved leave will remain on leave unless they request to telework. When the Federal Government is operating under an “Unscheduled Leave or Unscheduled Telework” status, the employee must inform his/her supervisor of his/her intent to telework or request to use unscheduled leave. The employee may use earned annual leave, compensatory time off, credit hours, sick leave (if applicable) or, leave without pay (LWOP). In the event of an administrative delayed arrival (i.e., the Operating Status is “Federal Offices are Open – XX Hours Delayed Arrival”), an employee scheduled to telework on the day of the announcement is expected to begin telework on time or request unscheduled leave, unless excused by his/her supervisor (see Q&A e. in the Work Schedule section in the DOE Desk Reference on DOE-Flex for examples of appropriate reasons). Employees on a situational agreement may request unscheduled telework in lieu of going into the office. Both employees scheduled to telework and those who request unscheduled telework must be prepared to telework the entire workday or take unscheduled leave, i.e., earned annual leave, earned compensatory time-off, credit hours, sick leave (if applicable), or LWOP, as appropriate, or a combination of telework and leave, for the entire workday. Employees on pre-approved leave will remain on leave unless they telework or report for work. In the event of an administrative early dismissal (i.e., the Operating Status is “Federal Offices are Open – XX Hour Early Departure”) and the employee is teleworking, he/she should continue to telework or as directed by the supervisor. When continuing work is not practical or feasible for some or the entire remaining work schedule, the employee must notify the supervisor, who will determine if the employee will be excused or must use leave. Employees on pre-approved leave will remain on .

k. Unscheduled Telework Approval. Employee will request approval prior to teleworking or as soon as his/her supervisor is available for each situation, even when Unscheduled Telework is authorized for a Situational telework arrangement. A supervisor’s email of approval will be sufficient documentation of the employee’s and supervisor’s actions, provided an agreement is in place. . l. Time and Attendance Reporting. Employee understands that NNSA must submit employee telework participation reports to DOE and/or OPM, as necessary. Therefore, all time worked while teleworking, including authorized overtime will be recorded in the DOE Automated Time and Attendance System. Normal policies and procedures apply for authorizing, approving, earning, and using leave, overtime, and/or compensatory time, and credit hours. The employee’s time and attendance must be certified by the Certifying Official to account for all hours (including telework hours) included in the work schedule. Time and attendance is reported as though the employee were at the duty station and applicable ATAAPS telework codes (Routine (Listed as Regular on ATAAPS) - TW, Situational - TS, Medical - TM) must be used. m. COOP. The employee and supervisor have discussed and agree that employees designated as Emergency Employees are expected to report to the designated work location and/or telework during COOP-related administrative or facility closures as directed by NNSA’s management, COOP NNSA SD-314.1 Appendix 7 5-15-17 AP7-9 Coordinator and/or NNSA’s COOP Office. All non-emergency employees with a telework agreement are expected to be prepared to telework. n. Furloughs. If you are designated as an essential (excepted) employee for furloughs, you are to report to the designated work location or, if authorized, telework. o. Telework/Equipment/Supplies Related Costs. There is no requirement in the law or DOE telework policy for Departmental elements to provide any resources when an employee is deemed eligible for telework. However, to the extent feasible, each program office may provide the necessary equipment/supplies from available surplus. The program office is not under any obligation to purchase extra equipment or supplies for this purpose, but it will not deny equipment to those who may need it. If equipment cannot be provided from available supply (including surplus), employees who wish to participate in telework will have to provide it through their own means. Employees will be allowed to use their own computers, fax machine, and/or telephone; and may be issued a calling card/loaner cell phone for long distance calling, and/or loaner air card for wireless internet access, as available. Participants who use their own equipment must ensure that adequate safeguards exist to protect the equipment and records. The Government will not be responsible for any operating costs that are associated with the employee using his/her personal residence as a telework site; e.g. home maintenance, insurance, or utilities. However, the employee does not relinquish any entitlement to reimbursement for authorized expenses incurred while conducting business for the Government, as provided by statute and implementing regulations,– subject to prior approval. When equipment is provided by the program office, supervisory approval is required on the NNSA Employee Telework Agreement, Section 4. NNSA/DOECOE retains ownership and control of any and all hardware, software, telecommunications equipment, and data placed in the alternative work site by the government.

p. Equipment Maintenance. Employee will protect any Government-owned equipment. The NNSA/DOECOE will maintain and service Government-owned equipment. The employee may be required to bring the equipment into the Federal office for service. The employee agrees to report problems with accessing the NNNSA’s/DOECOE’s network, supplied equipment, or software to DOECOE’s Help Desk and his/her supervisor. Upon suspension/termination of this agreement, all supplied resources must be returned to the NNSA/DOECOE. q. Liability. The Government will not be liable for damages to an employee's personal or real property while the employee is working at the approved telework site, except to the extent the Government is held liable by the Federal Tort Claims Act or the Military Personnel and Civilian Employees Claims Act. r. Telework Site. Employee will maintain a reasonably safe working environment, keeping it hazard- free and normally free from distractions; and ensure that the appropriate resources are available or accessible to perform work assignments at the telework site. s. Inspection. Employee understands that the NNSA may inspect the employee’s work site, to ensure that information systems and sensitive information is appropriately protected at the telework site; with reasonable notice to employee, providing there is no suspected or known security violation. If there is a suspected or known security violation, there may not be a notice. t. Government Records. The employee will protect Government records from unauthorized disclosure or damage and will comply with requirements of the Privacy Act of 1974, 5 U.S.C. 552a; Appendix 7 NNSA SD-314.1 AP7-10 5-15-17 and safeguard NNSA equipment, PII, and records and use such equipment and documents for official business only. The employee will ensure that unclassified work products are safely conveyed between a telework site and any other location; and classified work products are not taken to an employee’s telework site. u. Injury Compensation. The employee understands that if he/she is injured during authorized hours of work at the telework site while performing assignments, the employee is not covered by the Federal Employee Compensation Act (workers’ compensation) unless the injury occurs while performing authorized work. The employee must notify his/her supervisor promptly of any accident or injury that occurs at the telework site and complete any required forms. NNSA Officials and/or the Department of Labor may investigate such a report immediately. If the employee wishes more information on liability, she/he understands that this may be obtained from their legal support staff. v. Transit Subsidy. Telework agreements should correspond with any applicable employee transit subsidy benefits. The employee understands that if the telework arrangement affects his/her eligibility for parking or a transit subsidy, the employee is expected to follow the NNSA’s procedures to report the change and may lose or have his/her benefits reduced. w. Recertification. Telework agreements should be reviewed and discussed on an annual basis (normally at the time of the performance review), and recertified when there is a change to the telework agreement. Note: A new telework agreement must be signed and approved when the employee is placed under a new supervisor (not a recertification).

x. Effect of Failure to Fulfill the Terms of this Agreement. This agreement will be suspended or terminated if the employee fails to fulfill it or any amendment to its terms. Suspension or Termination for reasons of misconduct or failure to protect equipment, records, and/or data may result in disciplinary action and/or suspension or revocation of the employee’s security clearance, if appropriate. If the telework agreement is suspended or terminated, the employee may file a grievance under DOE O 342.1, Grievance Policy and Procedures. y. Termination. Either the employee or the supervisor can terminate the telework agreement. Management shall terminate the telework agreement should the employee's performance not meet the minimum standards, or the arrangement fails to meet the needs of the agency. In order to ensure that appropriate physical arrangements are completed at the employee’s official worksite, the employee should provide reasonable notice of desire to terminate this agreement. Management has the right to suspend, terminate, or modify this agreement at any time with reasonable notice. If the telework agreement is terminated, the employee may file a grievance under the DOE O 342.1 Grievance Policy and Procedures. NNSA SD-314.1 Appendix 8 5-15-17 AP8-1 APPENDIX 8: EMPLOYEE TELEWORK RECERTIFICATION FORM Complete this form annually to recertify a change to a telework agreement. Print or complete electronically. SECTION 1 SECTION TO BE COMPLETED BY EMPLOYEE Employee’s Name: Supervisor’s Name: a. Telework Arrangement: By mutual agreement between the employee and supervisor. Please check one box only, as appropriate. Routine & Situational Situational Medical & Situational b. If your work schedule has changed, please check the box to indicate your current work schedule. Basic Tour Compressed Work Schedules Flexible Work Schedules 8 Hour/Day Five- Day Workweek (M-F) 5/4/9 Four-Day Workweek Flexitour Gliding Schedule Maxiflex c. If your telework schedule has changed, please complete this block. In the chart below, provide your weekly schedule, specifying the day(s), hours of duty, (consistent with approved tour of duty unless change is approved in advance)*, and duty station. For each respective column under the Duty Station section, use an X to indicate the day(s) you will be at the official duty station the day(s) you will be at the telework duty station for Routine or Medical telework arrangements, as appropriate. For Situational telework agreements, complete only the Hours of Duty column, as appropriate. *Maxiflex and Gliding schedules may be adjusting accordingly. Pay Period Work Week Day Hours of Duty From To Duty Station Official Telework Site Week 1 Monday Tuesday Wednesday Thursday Friday Week 2 Monday Tuesday Wednesday Thursday Friday https://nnsaportal.energy.gov/intranet/na-mb/na-mb-10/flexiplace/SitePages/Home.aspx Appendix 8 NNSA SD-314.1 AP8-2 5-15-17 SECTION 2 SECTION TO BE COMPLETED BY SUPERVISOR The following checklist assesses the employee's eligibility to continue to telework. a. The employee’s NNSA Employee Telework Eligibility Notice/Application to telework is still current. If no, a new one has been prepared, completed and signed; and is attached to this recertification. Yes No b. The employee’s teleworking is not adversely impacting co-workers or the organization’s ability to accomplish its mission. If no, employee is telework ineligible. Yes No

c. The employee is able to telework without compromising sensitive information. If no, employee is telework ineligible. Yes No d. The employee has access to resources sufficient for his/her tasks/activities. If no, employee is telework ineligible. Yes No e. The employee’s performance rating is at or above Fully Meets Expectations or employee is on a PCM, PIP or PAP and has been approved to telework only in emergency situations. If no, employee is telework ineligible. Yes No f. The employee’s position description contains suitable work assignments (i.e. thinking and writing; telephone intensive tasks; and computer oriented tasks etc.) for teleworking. If no, employee is telework ineligible. Yes No g. There is no change to the NNSA Telework Self-Certification Safety Checklist. Yes No h. The employee’s duty location has changed. If yes, indicate the new location below: Yes No SECTION 3 SECTION TO BE COMPLETED BY SUPERVISOR AND EMPLOYEE Recertified Suspended Terminated a. I have reviewed and discussed the recertification decision with the employee. Supervisor’s Signature: _________________________________ Date: ____________ b. If suspended or terminated, concurrence required by 2nd Level Supervisor 2nd Level Supervisor: Concur 2nd Level Supervisor’s Signature: ___________________________________ Date: ____________ Employee’s Signature: ______________________________________________ Date: ____________ NNSA SD-314.1 Appendix 8 5-15-17 AP8-3 Note: If the recertification is not approved, the employee may file a grievance under the DOE O 342.1 Grievance Policy and Procedures. SECTION 4 ATTACHMENTS NNSA Employee Telework Eligibility Notice/Application Medical Documentation for Medical Arrangement SECTION 5 DISTRIBUTION* Supervisor Employee NNSA Telework Coordinator Time Keeper *Medical documentation is only provided to the supervisor and Telework Coordinator SECTION 6 PRIVACY The Telework Enhancement Act of 2010 (Public Law 111-292), Section 6120 of Title 5 to the United States Code, and Executive Memorandum of July 11, 1994 (59 FR 36017) authorizes collection of this information. Providing information and signing this application is voluntary, but failure to sign it will preclude the authorization for the employee to telework. The primary use of the information contained in this agreement is by applicable management officials and supporting administrative staffs, payroll and accounting staffs, human resource staffs, and NNSA Telework Coordinator to approve and record the NNSA Employee Telework Agreement. There are no additional uses that may be made of the information collected in the agreement unless otherwise allowed for in applicable regulations. The official copy of this agreement, which is -1 General Personnel Records system, is maintained by the NNSA Telework Coordinator. Furnishing the information on this form, including your home address, is voluntary. THIS PAGE INTENTIONALLY LEFT BLANK NNSA SD-314.1 Appendix 9 5-15-17 AP9-1 APPENDIX 9: EMPLOYEE TELEWORK SUSPENSION OR TERMINATION Print or complete electronically to suspend or terminate telework agreement. (Use the Tab Key to move from Field to Field/Double click on each box to fill, click on “Checked”, then click OK) SECTION 1 FORM TO BE COMPLETED BY SUPERVISOR OR EMPLOYEE Employee’s Name: Organization/ Phone Number: Supervisor’s Name: Organization/ Phone Number:

This is notification that the telework agreement which was signed on _______________________ is suspended or terminated effective _______________________. Suspension or termination from a telework agreement may be initiated by either the employee (Voluntary) or, the employee’s supervisor (Involuntary). Suspension (check appropriate box): Voluntary Involuntary Termination (check appropriate box): Voluntary Involuntary If involuntary, this decision was based on: (if additional explanation is necessary, add a continuation sheet) Reassignment or promotion to a new position not eligible to telework Reassignment to a new position with a new supervisor Failure to fulfill the terms of the agreement Failure to maintain eligibility in accordance with DOE O 314.1 DOE’s Telework Program Other (specify):_______________________________________________________________ If you would like to discuss this decision further, please let me know. An employee whose telework agreement is suspended or terminated involuntarily by his/her supervisor may file a grievance using the DOE O 342.1, Grievance Policy and Procedures. Employee’s Signature: ________________________________________ Date: __________________ Supervisor’s Signature: _______________________________________ Date: __________________ 2nd Level Supervisor’s : __________________________________ Date: __________________ SECTION 2 DISTRIBUTION Supervisor Employee NNSA Telework Coordinator Time Keeper https://nnsaportal.energy.gov/intranet/na-mb/na-mb-10/flexiplace/SitePages/Home.aspx