Board Of Aldermen - Agenda - 12/8/2020 - P161

APPENDIX C

GRIEVANCE FORM

LOCAL 2232 UNITED AUTO WORKERS

GRIEVANCE NUMBER: DATE OF FILING:
(MONTH DAY YEAR -INCIDENT#)

GRIEVANCE STEP1 STEP 2 STEP 3 OTHER
EMPLOYER RESPONSE DUE: Received by:

(Date) (Emp loy er Rep resentative)
TO:

(Name, Title of EMPLOYER Rep resentative)

OF:
(Employ er)
FROM:
(Name, Title of Union Rep resentative)
GRIEVANT(S):
DATE OF OCCURRENCE:

VIOLATION: The employ er violated the collective bargaining agreement including, but not
limited to Article(s)

ST ATEMENT OF GRIEVANCE:

REMEDY REQUESTED: The employer should make whole the grievant(s) in every way, including:

SIGNED:

(Union Representative) (Grievant(s) — optional)