Time Off Request STC

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Email *

Driver Name: *

Driver ID: 5 X X X X *

Car Number: *

Date of Birth: *

YYYY

Cellular Phone Number: *

Time off Start Date: *

YYYY

Time off End Date: *

YYYY

Reason:

Travel

Other

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Time Off Insurance *

Cancel Insurance

Tablet and Roof Sign must be returned to Driver Admin *

Yes

If any driver is away for more time off annually then allowed per collective agreement, driver will lose seniority and any benefits under the agreement. I have read and understood this statement. *

Yes

I clearly understand that during this period, there will be no insurance coverage of any type on my vehicle. I also understand that for my vehicle to be re-insured upon my return, I must first attend at the Coventry Offices, during business hours, in order to re-instate my insurance. I understand that the process to re-insure upon my return may take up to 24 hours. Certificates will be issued and sent to the city as promptly as possible, once received the driver will be notified and can start to work. *

Yes

I agree the information provided is true.I understand that I will be subject to discipline for any false information provided herein. *

Yes

For any other request, questions or concerns please contact driver admin @ 613-746-8740 ext: 3103 Dee, or ext: 3104 Kim or by email at driveradmin@coventryconnections.com between Monday and Friday 8:30am to 3:30pm.

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