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3.06 3.6 Labor&PolicyTeave of Absence Medical—William Hicks—8-6-12 RESOLUTION AUTHORIZING UNPAID MEDICAL LEAVE OF ABSENCE FOR WILLIAM HICKS RESOLUTION NO.: ,2012 INTRODUCED BY: WHO MOVED ITS ADOPTION SECONDED BY: WHEREAS, William Hicks, an employee in the Town of Queensbury Building and Grounds Department, is recovering from a serious illness, and WHEREAS, Mr. Hicks has requested Town Board approval to take an unpaid medical leave of absence as set forth in Warren County Civil Service Rule XIX, and WHEREAS, Mr. Hicks has submitted medical documentation supporting a need for medical leave, and WHEREAS, the Town's Facilities Manager has recommended that the Town Board grant Mr. Hicks such unpaid medical leave with an effective date of July 22nd, 2012 extending through the earlier of I. January 22nd, 2013, with the opportunity to extend such leave at 90 day increments; or 2. Certification of his physical qualification for return to work, documented by his physician in form satisfactory to the Town; and WHEREAS, in accordance with Warren County Civil Service Rule XIX, Town Board approval is discretionary and necessary before an employee may take such leave, and WHEREAS, the Town Board has carefully considered the circumstances of Mr. Hicks' request and the recommendation of the Facilities Manager, NOW, THEREFORE, BE IT RESOLVED, that the Queensbury Town Board hereby authorizes and grants an unpaid medical leave of absence to William Hicks with an effective date of July 22nd, 2012 extending through the earlier of 1. January 22nd, 2013, with the opportunity to extend such leave at 90 day increments; or 2. Certification of his physical qualification for return to work, documented by his physician in form satisfactory to the Town; and BE IT FURTHER, RESOLVED, that Mr. Hicks shall provide the Town with a status report from his physician regarding his ability to return to work and must notify the Town Board in writing by December 22nd, 2012 of his intention to return to work or request further unpaid medical leave and supply supporting documentation if he wishes to request additional unpaid leave beyond January 22nd, 2013, and BE IT FURTHER, RESOLVED, that the Town Board further authorizes and directs the Town Supervisor, Facilities Manager and/or Town Budget Officer to take any action necessary to effectuate the terms of this Resolution, and 2 BE IT FURTHER, RESOLVED, that this Resolution will not have any impact or create any inference as to any determination of entitlement to Disability or Workers' Compensation Benefits. Duly adopted this 6t''day of August,2012,by the following vote: AYES NOES ABSENT : 3