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Adjustable Desk Request Form
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The Connect4Health Program is proud to offer adjustable standing desks to our employees in an effort to encourage employees who are in mostly sedentary roles to increase movement throughout their work day. The City has designated funds from the Plano Partners program for adjustable desks which will be charged to the nondepartmental cost center. The City went through the procurement process and a contract was awarded to CDW, who resells Ergotron Adjustable Desks. There is one size and one color (white) to choose from, which is conducive to either a single or double monitor work space. Each department will have a cap of 10% of their department population. For example, a department with 70 employees will be reimbursed for a maximum 7 adjustable desks using Plano Partners funding. Additional desks may be purchased through the contract for your department if desired, however, this will be allocated to your cost center. If your department is interested in purchasing an adjustable standing desk through our Adjustable Desk Program, please designate one person to coordinate the requests. Please notify me directly, prior to placing an order, as to who the point person will be for all department requests in an effort to ensure proper administration of this program.
Adjustable Desk Program Guidelines
Please review the information below before submitting your request.
- Each department MUST identify a single point person in reference to desk orders.
- In order for a request to be completed, this request form must be submitted. All requests will go through Human Resources.
- The individual responsible for ordering adjustable desk(s) for their respective department will fill out this form and submit.
- The requests will be sent to CDW, our adjustable desk vendor, from Human Resources and desks will ship to the designated shipping address.
- Employees who receive a desk, MUST test the desk for a trial period of 15 days, prior to purchase. This allows for proper reassignment of the desk if employee is not satisfied.
*Once funds have been exhausted or the department has met their 10% cap, whichever may come first, departments may still purchase an adjustable desk at the contracted rate of $330 through CDW. Each department will be fiscally responsible for those purchases.
Description of Desk:
Color- White ONLY
Weight Capacity- 10-40 lbs
Work surface Dimensions- 37.5" W x 23" D
Keyboard Dimensions- 27.5" W x 11" D
Electronic Signature Agreement
I have read the above Adjustable Desk Program Guidelines and understand the process. If I have any questions about this process, I am instructed to contact Michelle Gifford at X7227 or email@example.com in the Human Resources Department.
Date of Request
Date of Request
Choose department from the options below:
-- Select One --
City Manager's Office
Parks & Recreation
Public Safety Communications
Other, if not listed:
Please enter your department if not listed as an option in the drop down.
Name of Person Placing the Desk Order
Please enter the address you would like the desk shipped to.
Please enter the number of desks you are ordering.
Email Address of Person Placing Desk Order
Give us your email so we can contact you with questions about this order.
Department Cost Center
Desk Recipient Names
Please enter the name(s) of the individuals who will be using the desk. Please use a comma between each person's name.
Ergotron Product Information Sheet
Ergotron WorkFit-TL 33-406-062- WHITE
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