Name of employer: _____________________________________________
Name of employee: _____________________________________________
Employee Classification/Wage Level: ______________________________________
Loaded Rate Range of Days: _____________________________________________
Loaded Rate Maximum Weekly Hours: __________
Loaded Rate Percentage: __________
Ordinary Hourly Rate: __________
Loaded Rate (ordinary hourly rate x loaded rates percentage): __________
Acknowledgement by Employer
The employer acknowledges that by entering into this arrangement, the employee must be paid the employee Loaded Rate for all hours up to the Loaded Rate Maximum Weekly Hours each week.
The employer acknowledges and agrees to roster the Loaded Rate Maximum Weekly Hours in accordance with the Loaded Rate Parameters defined in clause K.6 of Schedule K.
The employer acknowledges additional payments will apply to work performed on days, or at times, beyond the scope of the Loaded Rate Parameters, or for allowances not specified in the Loaded Rate Parameters.
By entering into this arrangement, the employer consents to any dispute arising from this arrangement being settled by the Fair Work Commission through arbitration in accordance with clause 40 – Dispute resolution and section 739(4) of the Act.
Name of employer representative: ________________________________________
Signature of employer representative: ________________________________________
Date signed: ___/___/20___
