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City of St. Louis Department of Personnel Administrative Regulation NO. 97- FORM |
The City of St. Louis Administrative Regulations have been converted to electronic format by the staff of the St. Louis Public Library. This electronic version has been done for the interest and convenience of the user. These are unofficial versions and should be used as unofficial copies.
Official printed copies of the City of St. Louis Administrative Regulations may be obtained from the Personnel Office at 1114 Market Street, Room 703, St. Louis, Missouri 63101.
Employee Secondary Employment Questionnaire
Article VIII, Section 8 of the Charter of the City of St. Louis prohibits city employees from engaging in certain types of secondary employment and prohibits employees from having any interest in a contract with the City. That provision provides, in pertinent part, as follows:
No officer or employee shall receive any additional compensation for serving in any other capacity under the city while in such office or employment; nor hold any office or employment under the state or United States except in the militia or as a notary public or as a teacher in a public educational institution. A teacher in a public educational institution may hold employment with the city. No officer or employee shall have a personal interest, directly or indirectly, in a contract with the city; and no elective officer shall be a member of the general city committee of any political party. Any person guilty of any willful violation of this section shall thereby forfeit his office or employment.
As noted, violation of the above provision may result in dismissal from city employment. In connection with secondary employment the above provision prohibits employment with the United States and with the State of Missouri and also employment under the state. Prohibited employment under the state would include, but is not limited to employment with another political subdivision, municipality, public school district, public board of education, Bi-State or the housing authority. In addition to the above, secondary employment may be prohibited if it is a conflict of interest.
Any questions regarding whether specific employment or contractual situations are prohibited by the Charter should be addressed, in writing to Linda Thomas, Department of Personnel, Room 100 City Hall.
City Policy on Secondary Employment
INSTRUCTIONS TO EMPLOYEE:
Complete two copies of this form. Both copies must be signed and
dated. Falsification of said forms may result in discipline including and up to dismissal:
NAME:_________________________________________________________________________
ADDRESS: ______________________________________________________________________
TELEPHONE/HOME: _______________________TELEPHONE/WORK:___________________
DEPT./DIV./SECTION:__________________________________ DEPT. NO. ______________
POSITION:______________________________________________________________________
WORK HOURS:________________________WORK DAYS:_____________________________
1. Are you currently employed in a job other than the one listed above?
No____ Yes____ If yes, complete the following:
NAME AND ADDRESS OF EMPLOYER(S)___________________________________________
POSITION:_______________________________________________________________________
WORK HOURS:_________________________WORK DAYS:_____________________________
2. Do you have a personal interest, directly or indirectly, in a contract with the City of St. Louis including any agency, division or department of the City of St. Louis?
No____ Yes____ If yes, complete the following:
TYPE OF INTEREST:______________________________________________________________
(e.g. contractor, employee of contractor, stockholder, officer or director of contractor, subcontractor)
NAME AND ADDRESS OF CONTRACTOR(S):_________________________________________
NATURE OF BUSINESS:____________________________________________________________
LIST CONTRACTS THIS BUSINESS HAS WITH THE CITY OF ST. LOUIS:
__________________________________________________________________________________
3. Do you have an interest in any business:
No____ Yes____ If yes, complete the following:
TYPE OF INTEREST:____________________________________________________________
(e.g. owner; employee, partner, stockholder, officer, director)
NAME AND ADDRESS OF BUSINESS:_____________________________________________
NATURE OF
BUSINESS:_________________________________________________________
I certify that all the information contained on this form is complete and accurate. I am
aware that any misstatement or omission of information provided on this form may subject
me to discipline up to and including dismissal. I am also aware that I am required to
immediately complete a new questionnaire upon changes in any of the above information. I
am further aware that all secondary employment must be approved by my Appointing
Authority.
Signed: ____________________ APPROVED: ____________________
Signature of Employee Appointing Authority
Date signed by Employee: ________ Date signed by Appointing Authority: _________
Revised: 01/01
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