Carlson Building Maintenance

Uniform Form

01/06/2024

All employees performing cleaning duties at site locations must wear either:

The employee may also wear the Carlson t-shirts while off duty, except that employees may never wear the t-shirts while working for another employer. This is to prevent confusion by customers or others.

The Company does not require employees to wear other specific items of clothing, except that for safety reasons employees must wear long slacks or jeans (rather than shorts or skirts). Shoes should be practical with closed toes (for example, no high heels or open toed sandals). Employees’ clothing, including the optional Carlson t-shirt if selected, are to be clean and presentable at all times at the assigned job location.

T-shirts can be purchased anytime at the cost of $7.00 per shirt. Payment will be taken through payroll deduction. Employees who wish to purchase shirts must complete this order form and give it to their manager, who will provide the employee with the requested number of t-shirts. The manager must forward the completed order form to the Payroll Department before the end of the payroll period.

PURCHASE OF T-SHIRTS IS COMPLETELY VOLUNTARY

Last name:

First name:

Employee #:

Address:

Apt:

City:

State:

Zip:

I wish to voluntarily purchase Carlson T-Shirts. I authorize Carlson to deduct the amount indicated below from my paycheck for the cost of the t-shirts. GIVE THIS ORDER FORM TO YOUR MANAGER OR MAIL TO HUMAN RESOURCES

Item and Cost

Quantity

Total to be deducted from paycheck

T-Shirt @ $7.00/ea

X

6

=

$42.00

Size: (Check one)

Employee signature:

Date:

01/07/2024

I provided the employee with the requested number of shirts by:

Mail

In person

Name:

Date: