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Sample <br />Pay Equity Implemt ntation Report 11/12/2010 <br />Part A:Jurisdiction Identification <br />Jurisdiction: Jurisdiction Type: <br />Contact: Phone:F-Mail: <br />Part B:Official Verification <br />1, The Job evaluation system used measured skill,effort 3. An official notice has been posted at: <br />responsibility and working conditions and the same <br />system was used for all classes of employees. <br />prominent location) <br />The system used was:Informing employees that the Pay Equity <br />Description: Implementation Report has been filed and is <br />availahte to employees upon request. A copy of the <br />notice has been sent to each exclusive <br />representative,if any,and also to the public library. <br />The report was approved'by: <br />2. Health Insurance benefits for male and female classes of govrMing body) <br />comparable value have been evaluated and: <br />chief elected official) <br />title) <br />Part C: Total Payroll Checking this box indicates the following: <br />signature of chief elected official <br />approval governing body <br />all Information is complete and accurate, <br />and <br />is the annual payroll for the calendar year just ended <br />rill employees over which the jurisdiction ties <br />December 31. final budgetary authority are included <br />Date Submitted: