2008 Compensation and Benefit Survey

Please complete each question as appropriate. If you need to further explain or clarify the answer to a question, please do so in the space provided at the bottom of the survey. If a question doesn't apply, please leave the default value provided by the form.

1. Organization: (Required)

2. Position title: (Required)

3. Total years as chief and/or assistant chief appointed official with cities/counties:

Years of service with current city/county:   Total years of service in cities/counties:

4. Highest level of education:

5. 2008 population:

6. 2008 current expense/general fund operating budget: $

7. Total number of permanent employees (all departments and funds):

8. 2008 monthly salary: $  (Do not include longevity pay, deferred compensation, or other similar pay.)

9. Are you a member of the State of Washington Public Employee's Retirement System (PERS)?: Yes No

If yes, Plan 1 Plan 2 Plan 3

If no, please explain what type of retirement program is being utilized and how it is funded:

10. Social Security or 401(a) replacement; please indicate below which plan, the amount paid by your employer and the amount paid by you:

Social Security participant 401(a) Social Security replacement plan Amount paid by employer: $   Amount paid by you: $

11. Please indicate the amount of any 2008 employer paid deferred compensation per month: $

12. Please indicate the amount of any 2008 longevity pay per month: $

13. Please indicate the amount of any 2008 other regular, monthly premium pay: $      Please explain:

14. Do you have an employment agreement or contract?: Yes No If yes, Please respond to item 27 at the end of this survey.

15. Insurance Coverage:

Insurance Type % Paid by Employee Employee Coverage Medical Yes No %   Dental Yes No %   Vision Yes No %   Dependent Coverage Medical Yes No %   Dental Yes No %   Vision Yes No %

Employee life insurance Yes No

Employee disability insurance Yes No

Insurance provider/plan:

16. Does your employer pay for membership in WCMA?: Yes No

17. Does your employer pay for attendance at WCMA Conferences?: Yes No

18. Does your employer pay for membership in ICMA?: Yes Yes No

19. Does your employer pay for attendance at ICMA Conferences?: Yes No

20. Does your employer provide an employer owned vehicle for your exclusive use?: Yes No

If no, do you receive: A monthly allowance: Yes No If yes, monthly amount: $   A mileage reimbursement: Yes No If yes, amount: (cents/mile)

21. Does your employer pay for moving expenses?: Yes No

22. How many days of vacation leave per year do you earn?:   Are vacation days paid at the time of separation?: Yes No If yes, what percent is paid?: %

23. How many holidays per year do you receive?:   Do you receive days off in addition to the state list?: Yes No If yes, how many?:   Are holidays paid at the time of separation?: Yes No If yes, what percent is paid?: %

24. How many sick leave days per year do you earn?: Are sick leave days paid at the time of separation?: Yes Yes No If yes, what percent is paid?: %

25. Other benefits, perks, etc., not mentioned above:

26. Please let us know if there are ways we could improve this survey or if there is other information that you would like to see included in future surveys.

27. Employment Agreement. If you answered "Yes" to item 14 (you DO have an employment agreement), please complete the following information. This will be compiled at MRSC, but will not be included in the final document. It will be available to WCMA members who ask for it.

If you DO have an employment agreement, please furnish a current copy to MRSC. E-mail is preferred. Send to lnordby@mrsc.org. If paper copy, please mail to Ron Bartels at MRSC.

27a. In the case of termination, how many days notice is your employer required to provide you?

27b. In the case of termination, how many days of severance will you be paid?

27c. In the case of resignation, how many days notice are you required to provide to your employer?

If the form doesn't submit, it means that an incorrect value was entered into the form. Please scroll up and review the form for error messages. They will appear next to the field in red.