a NOTICE OF DISMISSAL
. DISMISSALS REQUIRE A TERMINATION RECORD FORM TO BE SUBMITTED.
mesa-az {Refer to Management Policy 339 Implementing Corrective Action and Discipline)
Employee's Nome Mitchell Brailsford Employee's ID# 1986!
Employee's Position Title Police Officer
RC Name Superstition Patrol District RC #.
Supervisor's Name Sql. C. Langley or A/Sat, I, Zogiman(17973) Supervisor's Emp ID# 10509
In accordance with the City of Mesa Personnel Rules, this iso notify you that you have been dismissed
from your employment with the City of Mesa, effective at the end of your work schedule on
DY) 3/1
[Dismissal While on Regular Status: (Mark as many as apply)
IThe reason for this dismissal is Indicated below and was stated to you in the pre- pine id
lon (M/D/Y) 3/17/16
[Regular Status Positions: Should the empioyee desire fo appeal this dismissal, refer to the City of Mesa Personnel Rules
Lincompetence, inefficiency in performance Llsbsent without authosty
[labusivenessin atftude, language, or conduct Personal business on City time
EiViovation of potcy, lawful order, direction, requiation ]Uniawtut harassment/discrimination/retaiiation
EAccepting a bribe nd fo maintain minimum standards, licenses
Elusing 0° attempting undue infuence to obtain Failure to operate City vehicle in a sate, lawful manner
benefits or advantages Liknowingly destroying, deleting or altering documents
|Doiscreait, embarassment to City reloted to on investigation
‘Elcriminal conviction BRIA. # (PD oniy)
Fake statements, flitying documents other explain below)
Iniuing others, wasting pubic supplies
|fnecessary, explain futher or attach adattional popes:
Dismissal While on Initial Regular Employment Probation:
DiFailure to satisfactorily complete Initial Regular Employment Probation
in accordance with the Cily of Mesa Personnel Rules, he employee does not have the right 0 0 pre~
deprivation hearing or oppeal if cismissed while on Inilal Regular Employment Probation. Does not require
Deputy City Manager or City Manager/Assistant to the City Manager signatures below.
T z
Supervisor Date RC Manager/Division Director (If applicable) Date
4
Re :
2949, epulace
Department h/City Manager Designe Date Human Resaurces Direct Date
5 6
wy 3felig
Deputy City Manager ‘ily Manager/Assistant to the City Manager Date
(Requ/fed for regular siotus ang AL-Wil employees other than
pr-time, seasonal, ront-lunded, temporary, and employees on
Initil City Probation)ra ==Mesa PD
TAUnit
Officer Resume
Police Officer-Hta Mitchell M Bralstord [/19861]
Part I Personal Information
Name: Police Officer-Hta Mitchell M Bralsford
TD Number: 19861 Badge No: Hire Dt: 07/01/2013,
Bureau: Police
Division: Superstition Swing 1
‘Squad: ‘Superstition Swing 1
Part I~ Incidents
Use of force IA #: UOF2015-026 Case #: 20150230706
Received di
jan 23, 2015 Occurred date: Jan 23, 2015
Classification:
‘Allegation(s):
‘
Disciplinary action(s)
stow nin: eee
Incident summary:
Please see DR#20150230706 for further Information.Use of force IA #: UOF2015-297 Case #: 20152570695
Received date: Sep 14, 2015 Occurred date: Sep 14, 2015
Classification:
Allegation(s):
“
Disciplinary action(s)
Ineldent summary:
See DR for deta
Use of force TA #: UOF2015-315 Case #: 20152700672
Received date: Sep 27, 2015 Occurred date: Sep 27, 2015
Crassincation:
Allegations):
-
Discipinary action(s)
-
Incident summary
See DR
Citizen complaint TA #: 2015-238 Case #: 20152700672
Received date: Oct 22, 2015 Occurred date: Sep 27, 2015
Classification: 1A - Job Performance
‘Allegation(s):
Excessive Force < Open allegation >
Discipinary action(s)
‘
Tnédeat summary:
Is alleged
amount of force when they tou
custody.
InappropriateDepartmental IA #: 2015-223 Case #:
Received date: Nov 20, 2015 Occurred date: Oct 8, 2015
Classiication: TA - Attendance
Allegation(s):
Fallure to Appear - Admin Closed Nov 24, 2015
Failure to Appear-Court
Disciplinary action(s)
[NDA-Workstation File Entry Nov 24, 2015. Days/hrs suspended:
Incident summary:
(On 10-8-15 Officer Bralsford missed chil trafic cour. I spoke to Officer Bralsford who stated
he just missed it. Officer Brllsford stated he has never received notice for missing court prior
to this one at the Mesa Poice Department. Officer Bralsord signed for his subpeona on 8-14-
15.
11/24/15: Per Cmdr. Thompson, will Admin Close with WSF Entry,
'"** To be purged on 01/2019 **
Use of force IA #: UOF2016-020 Case #: 20160180586
Received date: Jan 19, 2016 Occurred date: Jan 18, 2016
Classitiatior
Allegation(s)
-
Disciplinary action(s)
-
Incident summary:
Please see departmental report for details of the incident,
Departmental IA #: 2016-017 Case #: 20160180586
Received date: Jan 22,2016 Occurred date: Jan 18, 2016
Classification: IA - Conduct Unbecoming
Allegation(s):
‘Conduct Unbecoming < Open allegation >
‘Conduct Unbecoming
Courtesy «< Open allegation >
\Wilful disobedience of Department rules or orders < Open allegation >
Disciplinary action(s)
-Incident summary:
It's alleged that Officer Mitchell Brailsford #19861 exhibited conduct unbecoming an officer
{and discourtesy by having utlized his department authorized rifle during duty hours while that
rifle was enscripted with profane language.
1/26)16: Case assigned to Det. Love and case on Criminal Hold.
41/21/16: Case reassigned to Sat. Castillo.
3/7/16: Case off of Criminal Hold, New due date is 9/3/16,
(03/21/16: Served with Notice of Dismissal (Termination effective 03/21/16).
"+94 Per Policy-KEEP INDEFINITELY ***
Departmental IA #: 2016-046 Case #: 20160180586
Received date: Feb 25, 2016 Occurred date: Jan 18, 2016
Classification: IA - Job Performance
Allegation(s):
Crime < Open allegation >
Discipinary action(s)
Incident summary:
(On March 04, 2016, Officer Mitchell Bralsford #19861 was charged with Second Degree
Murder by the Maricopa County Attorney's Office.
‘on Criminal Hold: 02-25-16"
3/7/36: Case off of Criminal Hold
(03/21/36: Served Notice of Dismissal (Termination effective 03/21/16)
Printed: Mar 24, 2016 12:58 By: Police Sergeant - SA Ed Castilo260+ 1} _001 M01] £L8L.Cd]
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esow Jo AIDPOST- CRITICAL INGIDENT LEAVE NOTICE
Incident Type/DR#: 422/20160180586 Incident Date: 01/18/16
Employed Nare/ID#t: M. Brallsford 18861 7 Home Phone ~
‘Home Address (Street Address): Contact Phone?
Employee Suporvisor: D. Doane 12354 Contact Phone —iaaaaS
Division Commender/Manager: J Thompson #11241
Assistant Buréau Chief/Designée: A Filler #9169 Contact Phone: 480-644-2505
‘The listed employee is being placed on Post-Critical Incldent Leave with full pay. Being placed ont
post-critical incident leave Is NOT a form of discipline. A Supervisor will review and complete this
form with affected employee.
During this leave you are hereby ordered to comply with the following cliecked glildolinigs (this list is
not all inclusive of your responsibllities): 1
Effective from _7/26/16__ (date) to _07/28/18 (date), 30 hours to __ hours yols shail bé on post-
critical incident ieave,
You are bY or are not ] required to attend @ post-citical incident-assessment appointment with &
licensed paychologist/psychiatrist as soon as practicable after the time of the critical incident. You are
responsible for notifying your immediate supervisor of your attehdance.to the appointment,
Ifyou ere unable to attend your scheduled post-critical incident appointment, as S60n as practicable,
Ypusal contac the peyholaisvpeehiete fst, theh your nines superv, andthe asijned
"Team member who made your eppointret
You! shall comply with DPM 1.4.15 (Administrative Reassignment & Disciplinary Suspension):
(C1 Armember shail not weir their oniforin while on any feave, dor take ary patios action other tan what
‘ifiine epeced of lize priaming ve dy
1 —_Amember is not authorized to work off-duty employmentto rclude uslforined off-duty, extra duty br
Petthanent off-duty j6bs while on I8ave, unless othenvise approved by Chief of Police or designee.
(During Weave, a member shall rian subject 6 Department ofders,
& - ACITY OF MESA INCIDENT REPORT (Industrial Commission Notification) was corfipleted
(inside inesaaz govisafetyformssinc rt. doex) pilot to eb of shit aid a copy is sentto
‘employee's chain of command.
[The Pser Support Team was notified or wil be notified at 480-250-3608.
Other; White on Post-Critical incident Leave:
Routing/Signatures
‘Supervisor Completing Form: 1. Note whether form signed by employee of verbal notification to thé employee. 2.
Email copy of fom decty to Time@mesaaz. ov before end of shit and include employee's Comimiander?Manager and
Kronos Timekeeper on email 3. Forward original copy through employee's chain of command for notion signatures
vie amal robin hard copy signtures. 4 Ensue immediate supervisor les completed for in employes
‘workstation fle,
t 01/26/16, a rm
Cieripeyee Signature; OR Ba Verbal Nofication Dats ‘Soperisor completing ‘Noliication Date
iitbanleatis Lee
FOR TIME & LABOR USE ONLY - Dato Entored: 1|)\\ |(p wk
Pw 21.1661 ‘Now 982018
4,
‘AsaTeiant CHET DatePOST- CRITICAL INCIDENT LEAVE NOTICE
icldent TypeDRE BS Jy 0/60) b00Bb incident Date: 79) Jy
Employes NameliO#. dy Oa weit 7 pqge, | Home Phone:
Home Address (Street Address): .
“[eontact tion: 74 una of |
Division CommandériManeger’ -v.. out Phono "TFeontact Phones yy = 3.16,
‘Assisiant Bureau Chief Mesignes: Contact Phone:
‘Tlie iisted!’omployeo is belng placed on Post-Critical Incident Leave with full pay. Being placed on
postoritcal incident leave Is NOT a form of discipline. A Supervisor will roview anid complete this
form with afécted employee.
During this head at iabrateee ordered to comply with the following checked. guidelings (this list is.
not all Inclusive
ad
ci
oa
a
‘your résponsibilities):
effectivateom 1114 Lo (ate) 16 Pat eet, baa usta L4oghours:you shell be on post-
iitical incident leave. fe Heanp T
You-ate$a.or are hit C1 reiquired to attond:a poeta ingident assessment appointment with a
licensed psychologis/paychiatrist a8 soon as, practicable efter the tne of the ‘celal ld You ate
responsible for notifying your immediate-supervisor of your attendance to the eppaintment.
1 Ifyou are unable to attend your scheduled! ical incident ippointinént, ag soon'as practicable,
onic the fetoeens fie then your Immediate supervieor, and the assigned
Feartewn nears rey
You shall comply with DPM 4.4.18 neem, an & Disciplinary Suspension):
o Agmamber sat nt eee anf ge eee nor take any police ection other theri what
be expected of a elizen
a Anarene at iho pe eee rl
permanent off-duty jobs ‘on leave, uriess otherwise ‘Police or designee:
a Brg leave, ¢ member sal remain eect to Deparimant orders.
A CITY OF MESA INCIDENT REPORT (Industrial Commission Notification) was completed
(inside. meena poesia senna Oe) prior fo end of shift and @ copy issent to
employee's chain of command.
‘The Peer Support Team was notified or will be notified at480-250-3608.
Ottior: While on Post-Critical incident Leave:
Rating signatures
ei an Note whether ‘8¢ verb noification to the employee. 2.
Era ot to [email protected] so ie of chi ard nls employes’ Corman
Commander/ilanager and
cheapo on eral 8 onward ga coy vous smpays eel of anmand fr noteaten dats
vie ‘eonler igen hae ‘signatures. 4, Ensure immediate suy ‘les completed form in employee's
a, Co
Sopa ae Dale
‘Astltant ONT ato
FOR TIME & LABOR USE ONLY -Dats
ion 250018
PM 2.4.16F1_" RE
EIVED
JAN
Me@Sa-az_ CITY OF MESA ~ EMPLOYEE PERFORMANCE APPRAI 4 20 ans
jel
Employee Name: ralisford, Mitchell M RC Name: Police Department:
Employee Number: 19861 RC Number; H210
Title: POLICE OFFICER-HTA. ‘Supervisor's Name: Wilson, Brandon S
Range “0 ‘Step: 062 ‘Supervisor's Emp: 16818
Review Date: 01/09/2015 Optional Rater's Name:
‘Second Review Date: ‘Optional Rater's Emp #:
Disciplinary Review Period: ‘Second Level Reviewer's Name:
From: Tr ‘Second Level Reviewer's Emp #:
‘Type of Appraisal: Merit and Probationery It Other, Spec!
Second Type of Appraisal:
‘Action @% Merit increase @& Probation Period Completed
Requested:) Merit increase Review Deferred Daysqeno) C) Probation Extended Days over t2n00)
O Merit Denied C1 Reduction in Pay (see reoms ie 00)
O 2.8tep Merit incrosse
Gi Unscheduled Mortt increase
Ci Salary Adjustment-Use this box for Open Pay Range ONLY-Indlcate Salary Below.
Chango Salary to: Biweekly Annual
Current Annual Salary: % Incrosse/Decrease:
‘Overall Rating: Successful Performance -
lol pte offs LEA GSE Wr
Sgt Carona Revo) tao Scpooors Ses Car
afr thot ua Vion Brandon 8,4 1018
1 No connensoguringPotomancs Apel, ployee St opr tal bs sachet
IB 820 Employer's Comments section.
aia ih, Bet EG a vey
Soelberg, Mickel Legrand »9e47
‘When fin! signature i complete, please forward PAF, Employee Se Appralsl end Computer Ackrowod Personne.
Officer Bralleford #19861 Is currently assigned to the Superstition Patrol Division 85 squad. Officer Bralleford
has been assigned to the squad since 10/06/2014 during which time | have been his immediate supervisor.
Officer Brallsford has met and exceeded the expectations | sot for the squad at the beginning of the year,
‘These expectations wore for each of my Officers to obtaln at least one on-view arrest, one flold Interview card
‘and one traffic complaint per comp-stat cycle while malntalning beat Integrity. Officer Brallsford Is
consistently wall above average for on-view arrests, fleld interviows, officer initiated traffic stops and street
lovel drug arrests within the squad, Officer Brallsford arrives promptly each day for work and displays a
Positive willing to lear attitude. Officer Brallsford responds well to feedback provided by his peers and hie
Supervisor, Incorporating feedback received into his policing Improving both his investigations and proactive
enforcement. Officer Brallsford completes thorough investigations and he writes well written easy to read
Eployee PAF Page 1 ofa DalaTime Printed: HAR0T6 at 0448 PMTCITY OF MESA -- EMPLOYEE PERFORMANCE APPRAISAL,
Employee Name: Brallsford, Mitchell M
Employee Number: 19861
reports Officer Brallsford froquontly conducts consontual contacts, which often result In arests. | have sted
one of these cases ae an example of his proactive onforcement efforts.
on 4112/14 Ofe. Brailsford conducted a consent stop on two subjects who were sitting in a bank parking lot
Sftor hours. Ofo. Bralleford recognized this was suspicious and contacted the subjects. Ofc. Brallsford
ebtained information from both parties but one of the names did not retum as valid. Ofe. Bralsford requested
@ Morpho Fingerprint Scanner and eventually determined the female suspect was providing falee information
Gnd discovered she had an outstanding Department of Corrections warrant. The female was arrested
{ransported back to DOC without incident. Ofc, Brallsford did an excellent job actively pursuing criminal
totivity when he observed suspicious activity via a consent stop and subsequently arrested an outstanding
folony offender. This Is an example of Officer Brallsford's work ethic and Inquisitive nature that often times
leads to proactive arrests
Officer Brallsford attended and completed AR-45 rifle schoo! end less lethal beanbag shotgun training during
this evaluation period resulting in two edditional resources for the equad. Based on Officer Brallsford's work
sthic, professionaliom, enthusiastic demeanor and proactive enforcement efforts | recommend Officer
Brallaford recelve a successful rating for this period and a completion of his probationary porlod,
Eiaployes PAF Page 20F4 DateTime Printed: TAROT at O78 PHCITY OF MESA - EMPLOYEE PERFORMANCE APPRAISAL.
Employee Name: —_Brallsford, Mitchell M
Employes Number: 19864
Successful a
Performance Required
4. Customer Service a o
2, Employee Development a a
3. Quality of Work a o -
4. Productivity CJ a
6. Communication Skitis. 4 a
6, Problem Solving/Judgment/Decision Making o
7, interpersonal Skilis @ Oo
8, Safety and Security a Oo
Maintain a professlonal appeerance and demesnor in allob-eleted contacts,
Superior Comments; OficerBratetord maintain a profesional sppearence et work and remain calm and efectve while perfoming
his utes.
Proficiency in fearme and oficer etety kil,
‘Supervisor Comments: OffcerBrasford completed AR-15t school with an expert marksman score. Officer Braistord hes
demonstrated profiloey with his primary weapon in order qual for tha ARTS,
Have primary respon ibility for an assigned ares or beat.
Suporiscr Commons: Offer Bralfords assigned to best 79 which has a high volume of alent cime and drug reed ectivty.
Officer Bralsfor prosctvely patrol this area and takes responstty forthe calle or serie that occur win his Beat Ofhecs ve ceford
‘malnain boat Integrly anc shares te workload vith his Beat partners,
Productivity
‘Supervisor Comments: Offa’ Bralsford consistent lead th squsd n on-view arrests and proactive enforcement efforts. Ofcer
Braisford targets high cme areas within Ns beat and focuses his tenon on those arees by enforcing minor afc Voltions feo
temp to develop lryor eases and kerf criminal offenders
Employee PAF Page 3 of4 Date/Time Printed 4Ha0V6 at 04:43 PAEMPLOYEE SELF-APPRAISAL
‘The Employee Self-Appraisal allows the employee the opportunity to provide input into the
development of his/her performance appraisal. Completion of the form is optional; however, the
Employee Self-Appraisal form must be attached to the completed Performance Appraisal Form
with the exception of Disciplinary Probation Reviews. The employee should complete the form or
indicate No Comments and retum it to the employee's supervisor by (Date)
Employee Name: M Qannsfor 19%el
a Va
Thinking back | PasFieieney WITH CeNBENT STOPS THAT LEA TO wana
over the appraisal |( omspierion OF SHOTGUN LESS LETHAL TRAINING
Period, ist your | Cavemen oF RIFLE OPERATOR HOO AL EKPET
Significant job- | AA OTAIN EXPERT WITH HANDGUN QUALIFICATION
related
accomplishments, |" MAINTAIN PHYSICAL FITNESS
Please include
any projects,
special
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that you think are
important,
lr word Lice TO ABET OM ANY TABK FORCE THAT IavelVES Since
What would you [C#MES 02 GANGS.
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year? Include MAWIAS FITNESS
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development
goals, interests, |isreaesr* goes
presekmment SHER SCHOOL
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[Proving orroatinines Foe ME TO DE RIDE ALONGE WITH CHET om GANG]
What assistance LSénb ME To SCHOOLS THAT WILL ASSIST IN A FRTHWAY TO CAEL ot
do you need from | Gaus,
your supervisor to vs
achieve these | @ANLE TIME
goals and to meet
your job
requirements?
ZA ib orprafens™
iployee's Signature Date NoComments
EmployeesetappraisaL OC 1128104 Paget%
CITY OF MESA - EMPLOYEE PERFORMANCE APPRAISAL
Employee Name: —_Brallsford, Mitchell M
Employee Number: 19861
Goa: .
~ATEND PHOS Bud Ab To LEAD ME TO THE PATH OF STREET
CRIMES ONT.
~(NWCREASE ARRESTS To aT LEAET ONE A DAY MINIMUM |
= RANGE TIME ATLEABT ONCE A MONTH
7 MAINTAIN EXPERT MARKSMANSHIP
T_MAINTAIN PHYSICAL FITNESS.
AIRE YS ELE AN EXTREMEN IMPORTANT ASSET TO. THE TREPARINEAT:
- Corsioaay (eats pow To BE A Mee EFRCWVE cFACER
1 Roses, Arty Apreeuare THE Posie FEEDBALK With MY EFFUETS AT woaK.
\ WWE CONTINUE TO SGRWE TO KREMER MYSELE DARY AND ENSURE A Distinct
PRAFESSIONAL DEMEANOR WHEN INTERACTING With THE PUBLIC To MAINTAIN A
POSINVE IMAGE FoR THE MEY Pouce DEPAgIMENT
No Comments (1
Employee PAF Page 4 0f4 - DDatoTine Printed: 4Ha016 a 04:43 PMEMPLOYEE ACKNOWLEDGEMENT
Information Security And
Computer Usage Policy
I hereby acknowledge receipt of the City of Mesa’s Information Security Policy
and acknowledge that | understand its contents and agree to comply with its
provisions. If applicable, | also acknowledge completing the annual security
awareness training requirement (ITD and employees processing credit cards
having access to credit card data). Since the Information contained in this
polley Is subject to change, | understand that It Is my responsibility to comply
with any revisions to this policy.
Employeo's Nome Brallstord, Mitchell M
Employee's Signature 490
poe O80 12(281T _——empoyeo Number 19081
Polley Acknowledgement Page off DatrTime Printed: 42/2016 at 04:43 PMCITY OF MESA
HR ORGANIZATION STRUCTURE CHANGE REQUEST
Employee Name: Brallsford, Philip Employee ID: 19861
Effective Date: 06/29/2014 Position Title: Police Officer Position #: 3054
RO#: 572 ‘New Supervisor's Name: Kurt Seanio 10H: 15840 Phone Ext: 4212
lick ts
Dat het ore Sm bas sae one | RE Cee |
Lunch Duration: None Actual/Observed Holiday: Actual ‘Scheduled Hours/Day: 10 |
Se ean
cheek on boxen tsppianr[_Towrime on Econ Tine Sele of Eset ota |
CommentsiJustification (if applicable): Completion of FTO PROGRAM
‘Send email confirmation to (Names): ARLENE HECKEL
Routing
Supervisor - to- HR Org Updates Outlook Group for processing
(NON POLICE DEPARTMENT CHANGES ONLY)
POLICE DEPARTMENT CHANGES ONLY:
‘SUPERVISOR - TO - LYNN STEWART for processing,
For Personnel/PD USE ONLY
Date Entered
in PeopleSoft
Notes: Staff Initials:
\WsreoathmgmtFORMSIHROrgStructureChange.docx 7/1/12Arlene Heckel
‘Tuesday, June 17, 2014 4:47 PM
PD Hiring Admin; POSecurity; PDSystems; i
; Mitchell Brailsford
‘Attachments: Brailsfordtransfer.docx
Effective June 23, 2014:
fe. Mitchell Brailsford #19861 will graduate the FTO program and will be placed at Fiesta on swings, S-
2, working for Sgt. Scanio, Congratulations!
PD Hiring Admin:
Please put Ofe. Brallsford in for his criteria based promotion to Police Officer effective June 23, 2014.CITY OF MESA
HR ORGANIZATION STRUCTURE CHANGE REQUEST
Employee Name: Bralleford, Philip Mitch Employee ID: 19861
Effective Date: 02/10/2014 Position Tite: Police Officer Reerult Position #: 3054
ROH 572 New Supervisors Name’ Brian Waltors | ID: 12196 Phone Ext: 4396
Dept: h210 Section: GRAV | Unit: REI2
Lunch Duration: None ‘ActualObserved Holiday: Actual ‘Scheduled Hours/Day: 10
eal ‘appicabley:
‘Check one box ony ( appicabiey: L_Joverime OR [XIcomp Time ee ee
Commentsiustfcation (¥ applicable): FTO PROGRAM
Sen eral confmation to (Names): ARLENE HECKEL
Routing
Supervisor - to - HR Org Updates Outlook Group for processing
(NON POLICE DEPARTMENT CHANGES ONLY)
POLICE DEPARTMENT CHANGES ONLY:
‘SUPERVISOR - TO - LYNN STEWART for processing
For Personnel/PD USE ONLY
Date Entores
Notes: in PeopleSot:
‘Staff Intials:
\WsreoathmgmffFORMSIHROrgStuctureChange docx 7/11/12aa
mesa-az
EMPLOYEE ACKNOWLEDGMENT
HARASSMENT/ DISCRIMINATION TRAINING
. STATEMENT
Illegal harassment and discrimination will not be tolerated. In order to provide a
productive and positive working environment, It is important to maintain a workplace
based on mutual respect. Therefore, all employees must read, understand, and
comply with the provisions outlined in Management Policy 308. This policy prohibits
unlawful behavior and identifies the confidential complaint procedure in place for
reporting, investigating, and resolving such complaints.
ACKNOWLEDGEMENT
I hereby acknowledge receipt of the City of Mesa’s Workplace
Harassment/ Discrimination Management policy (308). I also acknowledge I
have been trained on this policy, understand its contents including the
complaint procedure, and agree to comply with its provisions. Since the
information contained in It may be subject to change, I understand it is my
responsibility to comply with any revisions to this policy.
Employee’s Name (printed):
Pewie merece Reauseortds
Employee's Signature:
LEE hone
Date: _(l-Ze-/% Employee Number: _ 19861From: Arlene Heckel
Sent: Monday, November 18, 2013 1:36 PM
To: PD Hiring Admin; Lynn Stewart
Cer Dana McBride; Gregory Loewenhagen; Jonathan Klingler
Subje Recruits Timekeeping profiles
The following recruits will be graduating from the Mesa Police Academy this Thursday, Nov. 21, 2013 and will become sworn
officers,
Brailsford, Philip #19861
They will continue to report to training for the following (2) weeks for Mesa specific training. They will begin the FTO program
the week of Dec. 9, 2013.
files/Cy/Users"K Cunnin/Desktop/HRM%420F ling BrailsfordPhilp hr 12/1/2013 4:15:49 PM)oo . 14%]
Shaunna Smith
From: Christina Hatton on behalf of Time
Sent: Wednesday, May 22, 2013 8:58 AM
To: Tina Rogers; Time
Subject: RE: **For your approval - New Hire - Philip Brailsford (Police Officer Recruit)
This is approved.
Thanks,
Christina Hatton
From: Tina Rogers
Sent: Tuesday, May 21, 2013 1:55 PM
To: Time
‘Subject: “*For your approval - New Hire - Philip Brailsford (Police Officer Recruit)
Good afternoon,
Please review and confirm correct Kronos codes have been entered. This form was routed through NEOGOV
without Time and Labor selected as an approver. Thanks!
aa.
HIRE/PERSONNEL ACTION FORM
City: Mesa State: Arizona Zip: 85212
Person ID: — 11857883
Job Class #: 084330 Job Class: Police Officer
Hire Date: 07/01/13 Pay Rate: $1,960.00
Department: Police
Division:
Hire Req. #: 03223 Job Term: Full-Time
FORM INSTRUCTIONS: Copy and http://inside.mesaaz.gov/hr/office/Forms/NEOGOVHiteChangeInstructioy
he following web address into your webr
¢ Form Instructions.:
DEPARTMENT CONTACT #**###;
‘isor Name and extension/cell phone:
»nal Contact(s) Information:
ating Information for Pre-employment
tes. Please provide the accounting
ation that should be used to charge back
aployment expenses (fingerprinting, drug
medical examinations, respirator
ations, ete.)
iubFund/Dept/Unit/Appr/Object/Activity:
AAAMASECTION [+####A tm
Suffix:
AAAASECTION II#####644 a;
dle:
de:
1 Number:
position being underfilled?:
position is being underfilled, indicate the
illed position title.:
nel Action Code:
nel Action Reason:
‘ade:
This section identifies the Department contact(s) for this hire action. This,
be the hire's direct supervisor and any other person (s) that would need to
about the status of the hire action. This could also be the person that HR ¢
contact with any questions
Arlene Heckel X4385
Scott Montana X4267
Fund 1101 Dept F-210 Activity 1289
‘The information in this section is required for the integration process from
Integrated NEOGOV into Advantage HRM for all rehired/reinstated empl
This information can also be provided on New Hires, but its not required.
critical that the information in this section is confirmed in Advantage HR?
entered on the hire form exactly as it is shown on the previous employees
active employment record in Advantage HRM.
New
MR
Mitchell
Hire Information
Police Officer Recruit
4229
TRNG
2724
No
NG HIRE NEW EE
HIREce
itification for New Hire above first step:
Driven Pay:
ull-Time:
t Full-Time:
Member:
Local:
I Number:
ass:
ervice Status:
lass:
ment Type:
Pay Rule:
‘TION Ill (A) BASE PAY**#;
vent I:
nount Type 1:
nount 1:
CTION III (B) CAR AND PHONE
WANCES***;
ent 2:
vent 3:
CTION Ill (C) COMPONENTS FOR,
ND PD UNIFORM ALLOWANCE***;
ent 4:
nount Type 4:
aount 4:
‘ent 5:
nount Type 5:
nount 5:
016
‘The applicant will be starting at pay range/step 46/16 per the posted startit
salary for the position of Police Officer - Recruit.
Use Table
Yes
1.0
No
Biweekly
FULLTIME - HOURLY
CLASSIFIED
Full-Time
Permanent
FIN30L080
This hire action DOES NOT include pay based on an Open or Specialty p.
plan.
N/A
NONE,
NONErp
ent 6: ~°
nount Type 6:
nount 6:
ent 7:
nount Type 7:
nount 7:
“ent 8:
nount Type 8:
nount 8:
ent 9:
nount Type 9:
nount 9:
ent 10:
nount Type 10:
nount 10:
re here the City Manager approved
ynal Benefits such as vacation/sick bank
es, inereased vacation accruals, Deferred
:nsation contributions, Executive
als, additional Life insurance, ete.:
AeMSECTION [Veteteeaeet,
is a supervisory position?:
-Benefited PT and Seasonal: ASRS
vations shall be required by hire and
‘ment if the hire works 20 or more hours
ek for 20 or more weeks in a fiscal year
Rule). If position is Part-Time No
+s indicate anticipated number hours to
ked each week.:
rant-Funded, indicate Grant Expiration
ad have hire sign the Grant-Funded
wledgement Form. Open new browser
¥, copy/paste URL into browser for form
nsidemesa/hr/office/Forms/FM118.
rant-Funded, is position eligible for Step
ves?:
NONE
NONE
NONE
NONE
NONE
Additional Details About The Hire Action and Position Requirements
Noial Requirements & Certifications -
all that apply:
‘ial Requirements & Certifications -
all that apply:
ial Requirements & Certifications -
all that apply:
_Endorsement(s):
#kEHSECTION Versaaniiasy
{Director approved hire to start
‘ment (Note; hires requiring Police Dept
ice may not start employment prior to
sint results/clearance received).:
arting before fingerprint clearance, does
vartment want HR to conduct a web-
vackground check as part of the pre-
‘ment process?:
arting before fingerprint clearance, is
ticipated to be in contact with minors,
d or the homebound?:
1 for New Hires/Rehires: If starting
fingerprint clearance, will this individual
tinuously supervised until fingerprint
‘clearance is received?:
hire have access to Criminal Justice
2s and/or system:
riminal Justice facilities/systems access is
elect all that apply:
riminal Justice f
-elect all that apply:
ies/systems access is
‘#444*SECTION VItwenne ee:
ved Name:
Security Number:
yment Status:
itment Date:
ttment ID:
Pre-Employment Substance Testing
AZ Driving Requirement
Respirator Requirement
Applies to hires requiring background clearances as indicated in Personne
Rules, Section 210 - Dept Director approved individual to start employme
After fingerprint results /clearance received
Does not apply
Does not apply
Does not apply
Yes
Unescorted Access to PD Facilities
Access to AZ Criminal Justice Info System (ACJIS)
**HR ONLY** The fields below will be completed by HR upon success
completion of the pre-employment requirements,'s Progreasion Start Date:
Progression Start Date:
**4H1R OVERRIDES**######%; Human Resources Only
{on Start Date:
ion End Date:
licy:
‘ion Policy:
Policy:
Comments:
Smith,
3-Department Administrator Yu, Julie 05/02/13 10:50 AM.
firing Manager vin 05)
Prado sy 21, 2013ee bates soma
CITY OF MESA
PO Box 1466,
Mesa, Arzone 65211-1466
480-044-2758
| EMPLOYMENT APPLICATION
rallsford, Philip M.
(025844 POLICE OFFICER - RECRUIT
aa ava Eze
POL ‘OFFICER = RECRUIT
Recelved:
a
of, Official Use Only:
quan;
Jong:
‘aesperience
Btraining
aa a aa
ese Community College
‘BID YOU GRADUATET
Yes _aNo
rast, Cy, SEF CHA
0 en eck, rene Aran asi
TNark Combet ~ General Manager
'$800.00/month
Install, maintain and service alr conditioning uns
for commercial buldings
vac TechnicaPrt sown
volunteering efforts to collect canned goods forthe Shelter at Sunshine Acres.
Interests & Activities
Musidlan- Pove top—"-
Pte slate soem ach: ana 08
x
10.
a1,
a2,
Asency-Wide Questions
‘Are you a current City of Mesa employee?
No
Have you ever been employed by the City of Mesa - not through a temporary worker agency or contract?
No
‘Are you related to any City of Mesa amployee or » member of City Council, Advisory Board, or Comms
Yes
{Tf you responded ‘Yes' to the question above regarding a relative working for the City of Mesa, please provide the
me, department and relationship to you In the box below.
Griminal convctlons a erlminal conviction includes any mlademeanor(s) and fetony(es) (Le. asaault, burglary,
Sleorderly conduct, domestic violence, drug-related convictions, Driving Under the influence {DUE}, Driving Wille
{ntoxleated [DWI], fallure to appear ih cour, larceny, shoplifUng, trespassing, etc). Such conwiction(s) may have
resulted ina fine(s), community service, probation, or jallyprison ime: Applicants ere Wot required to report
Convictions that Rave bean expunged or sealed by & court of law. Since Your 8th birthday, have you been convicted of
{found guilty of or plead no contest to) any criminal offense!
No
11 you responded "Yes' to the Criminal Convictions question above, please Indicate the offensa(s) and approximate
‘ate(s) (month yeor) In dhe box below. Fllure to lst any criminal convietion(s) since your 18th birthday may result in
‘disquabiication of dlemiesal from employment. If you responded ‘No’ to the question, icicate N/A in tve Box below.
{Ihave not been convicted of any crime, I'm not certain why this application Is requiring me toil inthis section because I chose "No
amy response to question 5
‘raffle Violation Convictions within the past five years, have you been found ri
fine, or admitted responsibility for any fratic iolation(e)?
Yer
Xf you responded "Yes" to the Traffic Violation Convictions question above, please indicate dates and detalls of trot
slation(s) in the box below. Fallure to fist any Trafic Violation Convictions) within the pact five years may resultin
{isqunliticntion or offer of employment being rescinded. If you responded "No" to tne question, Ingleste N/A:
‘Speeding. approximately n 2007.
Ignition Interlock Device (11D) - where driving Is a job requirement of the position as indicated on the J
and/or Job posting, the chy of Mesa will not consider you or employment if you have Any existing TID requl
{through the Motor Vehicle bivision. Do you currently have an SID requirement on Your personal vehicle?
No
1f you responded "Yes'to the Ignition Interlock Device (11D) question above, please indicate the effective and
expiration dates of the IID requirement In the box below. I? you responded ‘Noto the question, indicate N/A.
‘Again I chose "No" for question 8, however, the application Is requlng an explanation. I've never had ané 1D.
Where did you frst learn about this employment opportunity?
Friend
Xf you responded to the employment opportunity question above, please specity (or website if not previous!
2 you reaper portunity qi ples ney or y
jonsible for, plead no contest to, paldL
mrpsateos sown
Job Specific Supplemental Questions
‘Are you a U.S. citizen?
Yes
Did you receive # High Schoo! Diploma or GED?
Yes
Will you be 21 years of age by November 22, 20137
Yee
‘Were you reterred for this position by an employee of the City of Mesa Police Department?
Yes
{Tf you responded ‘Yes’ to the question above, plesse provide the employee's name In the bx below.
‘This application was submitted by Philp M Brasford on 12/7/32 12:10 AMPhilip M.
Brailsford
Birthdate:
Objective
Education
Employment
Seeking stable employment with the Mesa Police Department
Desert Ridge High School
GPA: 3.5
Graduated: May 2009
Mesa Community College, 20 credits
Estimated graduation date: May 2015
2012-present (1 weekend a month): 11B ~ Infantry
Arizona National Guard
© Duty
© Honor
© Intey
© Personal Courage
2011-2012 (40 hours per week): HVAC Technician
Ontario Reftigeration, University Dr, Tempe, AZ
Repair, maintain, install air conditioning units
Mechanically inclined
Customer service face to face on a daily basis
Ability to work under high stress
Ability to manage time wisely
Ensure that the customer's needs have been met
Ability to be cordial and on time to jobsites
eeececa
2009-2011 (24/7): LDS Missionary (Mormon)
LDS Church of Jesus Christ of Latter day Saints
Quito, Ecuador
© Fluent in the language of Spanish (reading, writing,
speaking)
© Excellent in project management
© Ambitious
2006-09 (20 hours per week): Level 4 (Store associate)
IN-N-OUT burger, Signal butte, Mesa, AZ
© Maintain store cleanlinessHonors
Additional Information
References
e ee8e
eecce
Operate register as order taker
Operate register as drive-thru order taker
Prepare, cook, serve French fries
Eagle Scout
Fluent in Spanish
Excellent Communication Skills
Team Player
Outgoing and friendly
Goal setter and achieverSUPERVISOR ORIENTATION CHECKLIST
‘SUPERVISOR INSTRUCTIONS: Please review
signed by both of you and forwarded to Jackie Hale
is document with your new employee. The document must be completed and
Personnel within one week of your new employee's start date,
eMpLovee NAME: “Pacalelord “Wii Wishdnel
EMPLOYEE 1D:_\QB\ __
sop Tine: "Paice SPs Reco Hie DATE: _07/siaov___Row_ST)__
reas
WSLunch (When & Where) :
were
when late, sic, injured
industrial leave rules
ke leave rules**
Special leaves (death parental)
Vacation rules**
wore nun ENB oT
Hours ee.
WHO'S WHO (intro, if possible)
‘SPB Assign a buddy for the month
GAB Dept/Division’Section Head
‘BaBFellow workers
‘iBlmmediate Supervisor
SAFETY
PEA cident reporting**
(Chemical hazards and MSDSs**
Commercial Driver's License requirements
"___(Siat Statute Disquaifers)"™
FT Random Drug & Alcohol Testing Program***
vacualion/ Fire procedures
Pint Ald
Jobhousckeeping
sonal protective equipment
sical hazards
Respirator requirements
Safe ing methods**
Safety manual**
CITY VEHICLE (if applicable)
PMB Designated use
PUBFuel, ato system
TRAINING
Review Learning Center on Inside Mesa
view Employee Development Guide (Learning Center)
pt. Organization and required job training
edit Card Handling Training thru Accounting Services
(Mandatory only if processing custome credit cards)
Outlook/E-MAIL.
Fil out CAAR form for computer access (REQUIRED for
‘Timekeeping ~ Soe Forms TD, CAAR Form - Electronic
Computer Access (New)
1 to eal distribution lists
Complete Passwort Reset System process
‘Cnside Mesa Phone Book ~ complete "My questions”)
view Outlook tutorial with employee
POLICIES UNDERSTANDING AND ACKNOWLEDGMENT
(Gupervisor and employee please initial each line)
Empl Sener
Drug Free Workplace (316)**
Use of Computer Resources Including Internet,
~\ Inanet, E-Mail (326)
Pas Seat Belt Use (305-1)
Standards for Operating a City Vehicle (309)
DUI Policy 347)"
‘Workplace Violence (341)
Ba) ‘Workplace Fiarassment and Discrimination (308)
FMLA (G45)**
PERSONNEL RULES*
PEOvertime (350)
Stand by (360)
Standards of Conduct (510)**
WP Borievence Procedures (710)
PAYROLL INFORMATION
syheek Distribution
PERSONAL,
ress code/Appearance
Parking
‘smoking
Use of City phones
Vehicle Emissions Testing-Notice to Employces*
WHAT'S WHAT
Employee'sjob
[Equipmentand property
Pacilty our
'AIBFlow of work and office procedures (mailfax)
Funetionof employee's unit
Supplies and equipment
PERFORMANCE APPRAISAL angen a0
“RAB Review ENTIRE Peformance Appraisal ForySelf Appa
Form
RE complet Job Requirements/Standards or Performance
Expectations section of PAP
>robation/Merit date (provided to employee on first day)**
rniversary dates*
Job Description (copy provided in e-mail during pre
‘employment process)
+A copy of suid document is provided in the Employee Resource Guide given to employee on thelr frst day of employment.
‘tfa formation is also reviewed in New Employee Orientation - Part I. Howerer, the Supervisor i stil responsible for reviewing this
information with employee in more depth and as part of the supervisor orientation process.
‘eof an employee is na position regulated by DOT, HR will review the required information with the employee and provides
informational material tothe employee as part of the new employee required DOT/CDL, tr
LIST ANY-EQUIEMENT ISSUED,
Bruoyees Somture
‘Original to Personnel
ing.
SupeNhor's Signature Date
Fwi3ipoc 72Notice to New Employees
Arizona Minimum Wage Law
Arizona Revised Statute (A.R.S.) 23-364 (d), effective January 1, 2007, requires
employers to provide all new employees with a written notice of the employer's
business name, address and telephone number at the time of hire.
As a new employee of the City of Mesa, the following information is being
provided to you pursuant to the new minimum wage law requirement:
City of Mesa
Human Resources Department
Personnel Office
Physical Address Mailing Address,
20 E. Main St,, Ste. 130 P.O. Box 1466
Mesa, AZ 85201 Mesa, AZ 85211-1466
General Information
(480) 644-2365
City of Mesa’s official Website
www.mesaaz.gov
ee
Acknowledgement of Receipt
1, Paitin Wildl Beodsord, , acknowledge receipt of
my employer's business name, address and telephone number as listed above.
—S0Sane 0S
Signature of Employee
Employee #_\GRbo\
iprottswBeneit Pocket Originals Notice New Employees AZ Minimum Wage Law 409CITY OF MESA INFORMATION SEGURITY POLICY
PAGE 11
EMPLOYEE ACKNOWLEDGEMENT
Computer Usage Policy
| hereby acknowledge receipt of the City of Mesa's Information Security Policy and acknowledge that |
Uundorsend fs Conteris ane agroo to comply with ts provisions. It applicable, | iso acknowledge
‘completing the annual security awareness training requirement (ITD and employees processing credit
‘cards of having access to oredit card data}. Since tho information contained in this policy is eubject to
‘change, | undarstand that Is my responsiblity to comply with any revisions to this policy.
Employee's Name (printed)
Employee's Signature
Date; _BSSoneZOAB Employee Number: _\8otLoyalty Oath
State of Arizona, County of Maricopa
\ 5
‘Tame of Employee)
do solemnly swear (or affirm) that I will support the Constitution of the United States
and the Constitution and laws of the state of Arizona; that I will bear true faith and
allegiance to the same, and defend them against all enemies, foreign and domestic,
and that I will faithfully and impartially discharge the duties of the office of
Paice Officer aw
(Position Title)
according to the best of my ability, so help me God (or so I do affirm).
Datedin___ Has Arizona,
(Gig or Town)
onthis__\*__dayof _“S dy 20 ND
¢ ~ ae ‘of Employee)
Witness
hie cleLOYALTY OATH
I, the undersigned, hereby execute this document in compliance with Arizona Revised Statutes, Section 38-231:
OFFICERS AND EMPLOYEES REQUIRED TO TAKE LOYALTY OATH; FORM; CLASSIFICATION; DEFINITION
‘A. Inorder to ensure the statewide application of this section on a uniform basis, ach board, commission, agency
and independent office ofthis state, and of any of its politcal subdivisions, and of any county, city, town,
‘municipal corporation, school district and public educational institution, shall completely reproduce this section
so that the form of written oath or affirmation required in this section contains all ofthe provisions of this section
for use by all officers and employees of all boards, commissions, agencies and independent offices.
B. Any officer or employee who fails to take and subscribe to the oath or affirmation provided by this section within
the time limits prescribed by this section is not entitled to any compensation until the officer or employee does so
take and subscribe to the form of oath or affirmation prescribed by this section.
C._Anyolficer or employee having taken the form of oath or affirmation prescribed by this section, and knowingly at
the time of subscribing to the oath or affirmation, or at any time thereafter during the officer's or employee's term
of office or employment, does commit or aid in the commission of any act fo overthrow by force, violence of
terrorism as defined in section 13-2301 the government ofthis state or of any of its political subdivisions, or
advocates the overthrow by force, violence or terrorism as defined in section 13-2301 of the government ofthis
sate or of any ofits political subdivisions, i guilty ofa class 4 felony and, on conviction under this section, the
officer or employee is deemed discharged from the office or employment and is not entitled to any additional
‘compensation or any other emoluments or benefits which may have been incident or appurtenant to the office or
employment.
D. Any of the persons referred to in article XVIII, section 10, Constitution of Arizona, as amended, relating to the
employment of aliens, are exempted from any compliance with this section.
E. __Inaddition to any other form of oath or affirmation specifically provided by law for an officer or employee,
before any officer or employee enters upon the duties of the office or employment, the officer or employee shall
take and subscribe the following oath or affirmation:
‘As an employee of the City of Mesa, 1 do solemnly swear (or affirm) that I will support the Constitution of the
United States and the Constitution and laws of the state of Arizona; that I will bear true faith and allegiance to the
same, and defend them against all enemies, foreign and domestic, and that I will faithfully and impartially
discharge the duties of my position with the City of Mesa, Arizona, according to the best of my ability, so help me
God (or 80 I do affirm).
F. For the purposes ofthis section, “officer or employee’ means any person elected, appointed or employed, either
‘ona part-time or fulltime basis, by this state or any of its political subdivisions or any county, city, town,
municipal corporation, school district, public educational institution or any board, commission or agency of any
county, city, town, municipal corporation, school district or public educational institution.
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SOTYI JO popHuman Resources
mesa:az
NAME: Philip Brailsford EMPLOYEE #: 19864
JOB TITLE: Police Officer Recruit, RC#HIDept: H210/Police Department
HIRE DATE: o7101i13 BIWEEKLY/ANN. SAL: $1,960.00/$50,960.00
PROBATION DATE: 04/04/15 Pay Range/increments: 46/16
BENEFITS EFFECTIVE: WORK SITE PHONE #: (480) 644-4685
SUPERVISOR: Sgt. Gregory Loewenhagen
SUPERVISOR'S EXT. (480) 644-3468
FUTURE REQUIRED TRAINING
The following is a schedule of required training for all employees. You are required to attend this training as part of your
New Employee Orientation (NEO) program. A copy of this schedule has been forwarded to your Supervisor for reference.
Should you, or your Supervisor, have any questions about these classes or need to reschedule, please contact the
individuals) listed below.
‘The classes listed below will be held, on the dates and times specified:
NEO PARTI
New Employee Orientation and Safety Training
DATE: Tuesday, July 2, 2013 TIME:
CONTACT: Personnel, Jackie Hale (460) 644-4414
PLACE: — Central District Station
200 a.m. ~ 5:00 p.m.
NEO PART II - City of Mesa Overview and Customer Service
NEO PART Ill — Workplace Harassment & Discrimination
DATE: Tuesday, November 26, 2013 TIME:
CONTACT: Training and Development, Diana Aguero (480) 644-2904
PLACE: — Conference Room #550 South
Mesa City Plaza, 20 E, Main Street
00 p.m. - 5:00 p.m.
For employees who are not housed in the area of the plaza building, and will be driving to our classes, there is open
parking available on the upper level only of the Pepper Street Garage, located between Macdonald and Center Streets,
just east of the AZ Museum of Natural History.
20 E, Main St, Ste. 130
P.O. Box 1466
Mesa, Arizona 85211-1466
480.644.2365 Tel
480.644.2380 Fax?SUPERVISOR ORIENTATION CHECKLIST
SUPERVISOR INSTRUCTIONS: Pleese review this document with your new employee. The document must be completed and
signed by both of you ane forwarded to Jackie Hale in Personnel within one week of your new employee's start dat.
Delard Rot Viadnell
EMPLOYEE ID:_\XWo\
EMPLOYEE NAME:
sop tire: Paice Shee Recevt HIRE DATE: 67/61/2013 Rok_S71
WORK RULES POLICIES UNDERSTANDING AND ACKNOWLEDGMENT
Hours (Supervisor and employee please inital each line)
ets Empl §
BB Lanch (wnen & Where) ‘Drug Free Workplace (316)**
BWGOverine ‘Use of Computer Resources Incloding Internet,
POENotify when late, sick, injured
feet aren
Reece
Spee (sh a)
eee
WHO'S WHO (Intro, if posible
‘7 Assign a buddy forthe month
{HB Dept Division/Sesion Head
‘BuGFellow workers:
‘GAKImmediate Supervisor
SAFETY
PAGAccident reporting**
{PYG Chemical hazards and MSDSs**
ER Commercial Driver's License requirements
___(State Statute Disquaifirs)***
JOT Random Drug & Alcohol Testing Program***
Evacuation Fire procedures
First Aid
Job housekeeping
Personal protective equipment
DuBPhysical hazards
(WRespirator requirements
Safe lifting methods**
Safety manval®*
CITY VEHICLE (if applicable)
PR Designated use
PHF vel, auto system
‘TRAINING
Review Learning Center on Inside Mesa
view Employee Development Guide (Learning Center)
ep. Organization and required job training
redt Cand Handling Training thru Accounting Services
(Mandatory only if processing customer credit cards)
QutlooWE-MALL,
‘QERFill out CAAR form for computer access (REQUIRED for
Timekeeping ~ Sez Forms ITD, CAAR Form - Electronic
Computer Access (New)
i to e-mail distribution ists
Complete Password Reset System process
(nsideMesa Phone Book ~ complete "My question
QUE eview Outlook tutorial with employee
*A copy of
20144 Industrial? Mves Ono
Noxt Appointment Date:
O NO WORK STATUS: Effective from (date) to (date)
Q MODIFIED (RESTRICTED) WORK STATUS
Effective from (date) to (date)
Days Per Week _ Hours Per Day O Regular Schedule/Hours
Yo Repetitive Work: 0 Upper Extremities © Lower Extremities
O No Driving
No Operation of Heavy Equipment
No Overhead Work
Q No Climbing, Crawling, Kneeling, or Squatting
Q No Pushing/Pulling Greater than _-Pound(s)
O No Lifting/Carrying Greater than Pound(s)
No Twisting or Bending
O Limit Computer Keyboard work to_ minutes on minutes off
| 2 Limit Standing to minutes on minutes off
1 Limit Walking to minutes on minutes off
Q Other: (Please specify)
EXPECTED DATE OF RETURN TO REGULAR WORK: o sel
IS THE INJURY/ILLNESS PERMANENT? 1 YES Y4.NO__O UNDETERMINED
PHONE NUMBER DATE
RARE Goenan
ICIAN NAME (PRINT)
REV 01/02/2014aa Transitional Work Program
Request Form
ALD FORT
HRM Department # |--select Bogin Date | use Reza | End Date | Vuiy (dizer
Dacumontaton form your Docior regarding work alstus and rsticions must be aiached
Jf Work Related injuryiiness
"Body Parl(s)iness: Ceorm)
C Non-Work Related Injuryiliiness Date of injuryiiiness:
Body Parlyiiness:
Sie ees Nee AED
Case created by: Supervisor
‘Case updated by:
fl EREE
Employees: Continue following punch inpunch out requirements as established fr your postion and department
Supervisors: Prir tho end of each pay perio, you wil be responsible for overiting the pay code for your employee's tine
worked while workirg Ina lighvmosliied dkty capacity:
+ Use Light Duty Industral pay code for a work related Injury or iness,
+ Use Light Duty p nogyyotk rolategtfury or Irioss.
EMPLOYEE SIGNATURE
‘SUPERVISOR: SS
DEPARTMENT DIRECTOR
HUMAN RESOURCES DIRECTOR:
DEPARTMENT DIRECTOR:
HUMAN RESOURCES DIRECTOR: Ext. Date:
‘Original AND Required Medical information: Sofety Services Copy: Department File
Pollce Department Personnel: Complete additional paperwork por PO DPM 1.2.75 — Tra ta
evn 15/38Jody LaRoche
1 Patricia Bolanos
Sent: Tuesday, August 12, 2014 10:48 AM
Jody LaRoche; Ryan A Russell
FW: M. Brailsford 19861 Military Orders
image001.png; image002,png; image003 jpg
Fy
, Patty Bolanos, ASA I
QxE-- Superstition District
ew 480-644-4372
From: Talona Felix
Sent: Tuesday, August 12, 2014 10:13 AM
To: Patricia Bolanos; Kristin Hale
Cc: Diana Clevenger; Michael Soelberg
‘Subject: RE: M. Brailsford 19861 Military Orders
Patty,
‘Thank you for sending us a copy of Officer Brailsford military order!!! Office Brailsford has 240 hour remaining in his,
1 ary leave bucket. Baow is an Accrual detail report showing he started w/300 hour and the dates he used military
leave on... If you have additional questions please let me know.Brailford, Philip 1D: codooisss1
Discretionary Time Of (Hours)
Tue 72014 Eamed 1606 1600
Total Debi 1500 Total Cred 20
Donated Leave (Hours)
Sun 71/2012 Balance Fomward 00
Toul Debi 300 Total Create: 00
‘LW - Admin Leave (Hours)
Sun 72012 Balance Forward 0.00
Total Deb Too Total Cred oto
LV- FMLA (Hours)
Sun 7hv20%2 Balance Forsard a0
Tue 72014 Eamed 490.00 90.00
Tora Debi 600 Total Cred zoo
TV-FMLA Wil eg Houre)
Sun 7/2012 Balance Forward 0-00
Tue 72014 _Eamed 560-00 560.00
Total Deb 000 Total Creda: Se00
TV = Miltary (Hoare)
Sun 72012 Balance Fornard 0:00
Mon 372472014 Eamed 300:00 Grovp Esto
Wed 31282014 Taken 000 20:00 Leave -Mitary Schedule Ex
Thu Al102014 Taken ic-00 280:00 Leave -Mitary Schedule Ex
Fianvzov4 © Token 10:00 270:00 Leave -Miltary Schedule Ec
F520 Token 1000 250-00 Leave -Miltary Schedule Ec
at 513/2014 Taken 10:00 250:00 Leave - Military Schedule Er
nSid2014 Taken i000 240-00 Leave -Miltary Schedule Ec
Total Debite 0:00 "etal Credits 30:00Name 8 10
oadedt 9:55
Time Period
one ‘mount h Teanster
sun aro oop
%) BP aon ars . oop
KH! vueane : 20opa
TOTALS & SCHEDULE ACCRUALOVERVIEW ACCRUALLALASCES AUDITS SIGN-OFFS, REQUESTS & #
‘Accrual Profile 3-Police
‘oo ame in cg
LV FRILA Micg | 60:00 Hour en22a1e
Talona
From: Patricia Bolanos
Sent: Tuesday, August 12, 2014 9:51 AM
To: Kristin Hale; Talona Feli
Ce: Diana Clevenger; Patricia Bolanos; Michaet Soelberg
Subject: M, Brailsford 19861 Military Orders
Hi,
Attached are the military orders for Officer M. Brailsford 19861 from August 11! to August 29,
2014, Please let me know when the fime is available in Kronos so that | can code his
fimecard to Leave-Military pay code.
Thank you,
Patly Bolanos
Ext. 4372Mitchell Brailsford
Thursday, July 31, 2014 8:04 PM
Jody LaRoche
Subject: RE: Miltary time
Attachments: image002 jpg
| believe it is just the Leave ~ MIL, | have 240 hours of it left over,
Thanks,
Mitchell
From: Jody LaRoche
Sent: Thursday, July 31, 2014 3:35 PM
To: Mitchell Brailsford
Subject:
Mitchell,
| got your military orders from Sgt. Scanio. | ust need to know what pay code you want me to use. Military paid, military
k, vacation, comp. ete.
Thanks,
Jody
Set. Jody LaRoche #17484
Superstition 02
480-250-3138
[email protected].MeSa-az CITY OF MESA -- EMPLOYEE PERFORMANCE APPRAISAL
GENERAL INFORMATION
Employee Name: Brallsford, Mitchell M RC Name: Police Department
Employee Number: 19864 RC Number: H2t0
Title: POLICE OFFICER-HTA Supervisor's Name: Wilson, Brandon S
Range: 49 Step: 062 Supervisor's Emp #: 16818
Review Date: 0110912015 Optional Rater's Name:
‘Second Review Date: Optional Rater's Emp #: Cc
Disciplinary Review Period: ‘Second Level Reviewer's Nam OPY
From: To: ‘Second Level Reviewer's Emp #:
APPRAISAL INFORMATION
Type of Appraisal: Merit and Probationary If Other, Specify:
‘Second Type of Apprais:
Merit increase &% Probation Period Completed
Merit increase Review Deferred Daysomens (1 Probation Extended Days quert2nce)
Merit Denied Reduction in Pay seresowsinues 0)
2 Step Merit Increase
Unscheduled Merit increase
Salary Adjust ment-Use this box for Open Pay Range ONLY-Indicate Salary Below.
Change Salary to: Biweekly Annual
Current Annual Salary: % Increase/Decrea
Overall Rating: Successful Performance - 7 :
SIGNATURES
(jUaft 14861 js ZEA MESE Var
Gores Signaire exnowiodgirg Re Gate Supervisor Signature ate
Brallsor,Mltchol Mt, #19861 Wilson, Brandon $ ,# 16818
No Comments regarding Performance Appraisal.
GB See Employee's Comments section.
=z jets
Opal ign Signa
‘When final signature is compl
1d, please forward PAF, Employee Self Appreisal and Computer Acknowedk
SUPERVISOR'S COMMENTS
Note: FMLA absences shall not be discussed on Performance Appraisal.
Officer Brailsford #19861 is currently assigned to the Superstition Patrol Division $5 squad. Officer Brailsford
has been assigned to the squad since 10/06/2014 during which time | have been his immediate supervisor.
Officer Brailsford has met and exceeded the expectations | set for the squad at the beginning of the year.
‘These expectations were for each of my Officers to obtain at least one on-view arrest, one field interview card
and one traffic complaint per comp-stat cycle while maintaining beat integrity. Officer Brailsford is
consistently well above average for on-view arrests, field interviews, officer initiated traffic stops and street
level drug arrests within the squad. Officer Brailsford arrives promptly each day for work and displays a
positive willing to learn attitude. Officer Brailsford responds well to feedback provided by his peers and his
supervisor, incorporating feedback received into his policing improving both his investigations and proactive
enforcement. Officer Brailsford completes thorough investigations and he writes well written easy to read
Employee PAF Page tof 4 Date/Time Printed: 1122016 at 04:43 PMEmployee Name: —_Brailsford, Mitchell M
Employee Number: 19864
CORE VALUES - ALL EMPLOYEES
Performance
Successful
Performance improvement
Required
4. Customer Service
2. Employee Development
of Work - %
4.Productivity 4 oT
5.Communication Skills _® a
%
7. Interpersonal Skills _ v a
. Safety and Securi
JOB REQUIREMENTS/STANDARDS OR PERFORMANCE EXPECTATIONS
(Minimum of 3 Required)
Maintain a professional appearance and demeanor in all Job-elated contacts.
‘Supervisor Comments: Offcer Bralsford maintsins 2 professional appearance at work and remains calm and effective while performing
his dutes.
Proficiency in firearms and officer safoty skis.
‘Supervitor Comments: Officer Bralsford completed AR-15 rile school with an expert marksman score. Officer Bralisford has.
{demenstated proficiency with his primary weapon in order to qual forthe AR-A5.
Have primary responsibilty for an assigned area or beat.
‘Supervisor Comments: Officer Bralsord is assigned to best 73 which has @ high volume of violent cme and drug related activity.
(Officer Bralsford proactively patrols this area and takes responsibility for the calls or service that occur within his beat. Officer Braistrd
‘maintains beat Intagrty and shares the workload wit his beat partners.
Productivity
‘Supervisor Comments: Officer Bralsford consistent leads the squad in onview arrests and proactive enforcement efforts, Officer
Brailsford targels high rime areas within his beat and focuses his atlenton on those areas by enforing minor trafic violations in an
‘atiempl to develop larger cases and Identify criminal offenders.
“Employee PAF Page Sof4 Date/Time Printed: 4/12/2018 at 04:83 PMEmployee Name: Brallsford, Mitchell M
Employee Number: 19864
EMPLOYEE'S COMMENTS
(Tho employee has 3 working days to comment or indicate No Comments and return the PAF tothe rate.)
Goaves - x =
—_ ATEND BHOOLS DAM AD TO LEAD ME TO THE PATH OF STREET
CRIMES ONT, pr
= ANCREASE ARRESTS TO_ay LEAST ONE A DAY Minimum.
= RANGE TIME ATLEART ONCE A MoNTH
MAINTAIN EXPERT MARASMAN SHIP,
MAINTAIN PAYSICAL FITNESS.
MAKE MYSELE AN EXTREMELY IMPORTANT ASSET TO THE DEPARTMENT.
ALY LEARN HOW TO BE A More EFRCWE orrFiceR
POSTIVE FEEDRAUK With MY EFFatS AT WouK.
\_ WISE CONTINUE TS SIRWVE TO BENE MYSELF DAWY AND ENSURE A TastiNcT
PROFESSIONAL DEMEANOR WHEN INTERACTING WITH THE PUBLIC To MAINTAIN A
POMIMME IMAGE For THE MEYS PoLice DEPAZIMENT ,
No Comments 0
Employee PAF “Date/Time Printed: 42/2048 at 04:43 PM~~ COPY
MeSa-az CITY OF MESA -- EMPLOYEE PERFORMANCE APPRAISAL
GENERAL INFORMATION
Brailsford, Mitchell M RC Name: Police Department
19861 RC Number: H2t0
POLICE OFFICER-HTA Supervisor's Name: Wilson, Brandon S
Rang POFCR Step: 082 Supervisor's Emp#: 16818
Review Date: 07/01/2015 Optional Rater’s Name:
Second Review Date: Optional Rater’s Emp #:
Disciplinary Review Period: ‘Second Level Reviewer's Name:
From: To: ‘Second Level Reviewer's Emp #:
APPRAISAL INFORMATION
Type of Appraisal: Annual Hf Other, Speci
Second Type of Appraisal: Merit Increase Regular Pay Ranges _
Action % Merit Increase = Probation Period Completed
Requested:!” Merit Increase Review Deferred Days oxen Probation Extended Days o1ex:2%a9
_ Merit Denied J Reduction in Pay (seePesrrei e220)
2 Step Merit Increase
[3 Unscheduled Merit increase
© Salary Adjustment-Use this box for Open Pay Range ONLY-Indicate Salary Below.
Change Salary to: Biweekly Annual
Current Annual Salar % Increase/Decrease:
Overall Rating: Successful Performance
Me eS
EVE Sy
Vi ss
rallstord, Mitchell M, # 19661 Wilson, Brandon S ,# 16018
[FEI No Comments regarsing Perfomance Appr [eErployee Set Appraisal shall be attached.
BE ces cngtyees Commons scdon
_ “abe Fhe MY our
‘When final signature is completed, please forward PAF, Employes Sel-Appraisel and Computer Acknowledgement forms to Personnel
SUPERVISOR'S COMMENTS
Note: FMLA absences shall not be discussed on Performance Appraisal.
Officer Brailsford #19861 is currently assigned to the Superstition Patrol Division SS squad. He has been
assigned to the squad since 10/08/2014 during which time | have been his immediate supervisor. Officer
Brailsford has met and exceeded the expectations | set for the squad at the beginning of the year. The:
expectations were for each of my Officers to obtain at least one on-view arrest, one field interview card and
one traffic complaint per comp-stat cycle while handling calls for service in his beat. Officer Brailsford is
consistently well above squad average for on-view arrests, field interviews, officer initiated traffic stops and
street level drug arrests.
Officer Brailsford arrives promptly each day for work and displays a positive attitude. Officer Braitsford
responds wello feedback provided by his peers and his supervisor, Incorporating feedback received into his
Employee PAF Page 1 0f4 ‘Date/Time Printed: 4/27/20%6 at 08:46 PMCITY OF MESA -- EMPLOYEE PERFORMANCE APPRAISAL
Employee Name: —_Brailsford, Mitchell M
Employee Number: 19864
policing which has improved both his investigations and proactive enforcement, Officer Brailsford completes
thorough investigations and well written easy to read reports. Officer Brailsford frequently conducts consent
contacts, which often result in arrests. An example of his proactive enforcement efforts is listed below.
On 04/04/2018 Ofc. Brailsford conducted a knock and talk consent contact at the Colonade Motel located at
5440 E. Main St. at a motel room where numerous people had advised Ofc. Brailsford drug sales were
‘occurring. Ofc. Brailsford contacted two occupants at the motel room and obtained a verbal consent to enter
the room where he began speaking with a male and female occupant. He inquired about drug usage and where
any drugs were currently in the room. The male suspect then produced a metal tin that contained numerous
used needles, methamphetamine and a meth pipe. Ofc. Brailsford seized the items and arrested the subject.
fe. Brailsford contacted CINET and informed them of the case, and expressed an interest in working the
case. Ofc. Brailsford demonstrated great initiative on this case and showed his ability to develop a consent.
encounter into an arrest situation,
Officer Brailsford attended and completed AR-15 rifle school and less lethal beanbag shotgun training during
this evaluation period resulting in two additional resources for the squad, Ofc. Brailsford also attended the
Dale Anderson search and seizure school during this evaluation period. Based on his work ethic,
professionalism, enthusiastic demeanor and proactive enforcement efforts | recommend Officer Brallsford
receive a merit increase and successful rating for this period.
Gedy. 1987
Erloyee PAF Page 2of@ — DateTime Printed: aarreneat 0B: PIACITY OF MESA -- EMPLOYEE PERFORMANCE APPRAISAL
Employee Name: _Brailsford, Mitchell M
Employee Number: 19861
CORE VALUES - ALL EMPLOYEES
Successful porformance
Performance mprevenien|
Required
g uw
3. Quality of Work
4, Productivity
8. Communication Skills
JudgmentiDecision Makin,
7. Interpersonal Skills
8, Safety and Security
JOB REQUIREMENTS/STANDARDS OR PERFORMANCE EXPECTATIONS
(Minimum of 3 Required)
Maintain professional appearance and demesnor inal ob-eated contact,
‘Supervisor Comments: Officer Bralsford maintains @ professional appearance at work and remains calm and effective while performing
is duties.
Proficiency in firearms and officer safety skills
Superisor Comments: Officer Brailsord completed AR-15 rie school with an expert marksman scare, Officer Bralford has
‘demonstrated proficiency with his primary wespenby qualtying with an expert marksman score.
Have primary responsiblity for an assigned area or beat.
‘Supervisor Comments: Officer Bralsord is assigned to beat 73 which has @ high volume of violent crime and drug elated actvty
Ofcer Bralstord proactively takes responsibil forthe calls for service that occur within his Beat. Offer Ballsfors
‘maintains beat integrity and shares the workioad with his best partner,
Productivity
‘Supervisor Comments: Officer Bralsfocd consistently leads the squad in or-view arests and proactive enforcement efforts. He targets
high crime areas within his beat and focuses his attention on those areas where he enforces traffic lawe and conducts frequent consent
contacts
Maintain a working knowledge of current COMPSTAT statistical analysis regarding crime trends within the district and assigned beat
‘and utlizes Information ina proactive manner.
‘Supervisor Comments: Ofc. Bralsford understands the importance of accurate cutrent data t in order to track crime trends in his beat
(Of. Bralsford utitzes the dally mission to track requent offenders in his ares,=
mesa-az EMPLOYEE SELF-APPRAISAL
The Employee Self-Appraisal allows the employee the opportunity to provide input into the development of hisiher
performance appraisal. The employee shall complete the form or indicate No Comments and return it to the
employee's supervisor by 04/18/2015 (Date). The Employee Self-Appraisal form must be attached to the
sompleted Performance Appraisal Form with the exception of Disciplinary Probation Reviews.
[Employee Name: M. Brailsford #19861 Review Period: 4/29/15
[ — EMPLOYEE SELF-APPRAISAL
(Boxes below will expand to ft your text)
Thinking back over | OVER THE LAST ePFeRISAL PemeD | HAVE BEEN ABLE TO MAMAS
the appraisal period, | Ex7e2T MARKSMAN SHI? WiTH HANDGUN AND giFle, | HAVE
Vist your significant | seven BEM LATE To work. | HAVE BEEN ABLE TD MANTA
Socomplshments PHYSICAL FITNESS STANDARDS, | HAVE BEEN A PRO-ACTIVE
Please include any | oFFiten AND HAVE Not SusTMWED ANY COMPURINTS AGAINST
projects, special He.
assignments, etc
that you think are
important.
Whe ld lik Oven THE NEXT YEAR § WEVLD LIKE TO MAINTAIN AU OF
Whatwouldyoulke | Te pgove LISTED GOALS. | Und time TD TARE covRses
the next year? THAT CAN HE TEACH HE TO BE A BETTER INVESTIGATR
inch
profesional AND SoMEDAY PLEPARE MED TET INTO THE STREET COMES
development goals, | OAT.
interests, or
assignments,
Pravile A MEANS ONLE A MONTH TR GO To THE RANGE
Whatassistancedo | goa A PRACTICE DHOST.
roeneor te aanleve Atrow FoR RIDE-ALONGS WITH STREET CRIMES oF oTHER
these goals andto | UNsTS.
meet your job
requirements?
tis incumbent upon CITY COUNCIL STRATEGIC INITIATIVES - EXECUTIVES ONLY
every Executive to | a
continuously and lease refer to the City Council Strategic Initiatives for detailed descriptions of each initiative.
actively support the | Economie Development Community Engagement Qual of Life Regional Leadership Financial Stability |
accomplishment of |_| Please comment on your efforts in support of one or more City Council Intiative(s):
City Council's
initiatives through the
achievements of their
Work groups and the
actions they take as
managers of City
operations.
Z9her 0/3 — tha, fh el
mployee’s Signatui Date No Comments []
‘Seltappraisal.00C 7108 PagetCITY OF MESA ~- EMPLOYEE PERFORMANCE APPRAISAL
Employee Name: —_Brailsford, Mitchell M
Employee Number: 19864
EMPLOYEE'S COMMENTS
(The eniployee has 3 working days to comment or indicate No Comments and return the PAF to the rater.)
No Comments
“Employes PAF PagesoféEMPLOYEE ACKNOWLEDGEMENT
Information Security And
Computer Usage Policy
‘hereby acknowledge receipt of the City of Mesa's Information Security Policy
and acknowledge that I understand its contents and agree to comply with its
provisions. If applicable, | also acknowledge completing the annual security
awareness training requirement (ITD and employees processing credit cards
having access to credit card data). Since the information contained in this
policy is subject to change, | understand that it is my responsibility to comply
with any revisions to this policy.
Employee's Name Brailsford, Mitchell M
Employees Signature 19hb6/
pate _ Soff 20s Employee Number 19864
Policy Acknowledgement Page 1 of 1 Date/Time Printed: 4/19/2018 at 03:06 PMBrandon Wilson
Mitchell Brailsford
Monday, October 27, 2014 1:55 PM.
Brandon Wilson
Subject: FW: Rifle Operator Schoo!
From:
From: Trevor Honomichl
Sent: Monday, October 20, 2014 4:30 PM
To: Brandon Hamilton-Prucha; Brandon Lavin; Craig Churella; Ty Morrison; Mitchell Brailsford; Nathan Long; Treve
Widmer; Scott Muth; Graham Hatch; Kyle Stewart; Andrew Gonzalez; Jason Blomberg; Clayton Thomas; Matt Mortenson;
Trevor Stadler; Jonathan Poterson
Cet Robb Ashcroft; Richard Worrell; Mark Njaa
Subject: Rifle Operator Schoo!
You have been accepted for the rifle operator school. The school starts on Monday December 15" at 0700 in the
classroom and runs thru Friday December 19”, These will be long and tiresome days. Even though it’s in December make
sure you bring plenty of water to drink. As fer as clothing some type of BDU pants is recommended but anything will do.
Remember these pants are going to get very dirty and a good chance they could get ruined from oll, grease and dirt.
Wear 2 long sleeve shirt or sweater because it will be cool in the morning but warm up in the afternoon. The night
shoot will be on Thursday and that will be a long day. We will start at 1200 and go to 2100. | saw that some of you had
different dates listed on your training request. Make sure that you can attend the dates | have listed because those are
the correct ones. If each of you will let me know if you will be attending that would be great. 100% attendance is
required. if you cannot attend everyday then you need to let me know ASAP so I can get a replacement, if you have to
miss an hour or 2 because of court we can make that up. That would be the most time you can miss. if you have court
that is going to last for @ day or for several hours then you need to let me know so | can get a replacement
Here are some other items that you might want to invest in:
Boonie style hat
Knee pads
Elbow pads
Camelback
Scarf, bandana or a schmog to protect neck from hot brass
Your duty belt with pistol
Sunscreen
‘And this is for extra credit, if ou can tell me what movie this is from, without looking it up on internet or
anything else. Just from your knowledge.
“Bring a bed roll, couple of good ropes, horse if you got one. You'll get the best food in the territory, no rest,
damn little sleep. And fifty big silver dollars, if we make it to Belle Fourche. Now, you will show up at my place first
Monday after school is out at 5:00am and come with grit teeth, cuz gentlemen, that’s when school really begins.”oumpsuy jusuoSeuEyy Aouskiowy (cen NAO LAOVI £0
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mesaaz CITY OF
MESA INCIDENT REPORT
INCIDENT/INJURY/MOTOR VEHICLE COLLISION/PROPERTY DAMAGE
NOTIFICATION (Sce Safety Plan SS-200 - Accident Reporting)
Incident reports must be submitted within 24 hours to
reported immediately
Safety Services
Safety Services (480) 644-3331
+ Email“Safoty Services”
+ Fax (480) 644-5489
Safety Services and City Attorney. Fatal Incidents must be
City Attorney
> Claims (480) 644-3330
+ Email “[email protected]"
© Fax (480) 644-2498
INCIDENT
Date of Incident: 627-16 Time of incident. 2300
Location of Incident: 1166 N Higley Date Incident was Reported
Location Address Faciity (F applicable)
1166 N Higley Mesa, AZ
INCIDENT TYPE (Mark ail that apply) VEHICLE COLLISION TYPE (Mark all that apply)
DZ trjuy Backing
Vehicle Collision (2500) Other Vehicle hit City Vehicle
1 VehiclerProperty Damage (2505) 1D Gity Vehicle hit Other Vehicle
Property Damage or Loss (2000) Hit Pedestrian
C1 Other: Hit ObjectAnimal
OD _ Rolt Over
City Vehicle #: Dl Side Swipe
License Plate #: Q jing a City CMV
Other:
Police Report #: - Other:
INCIDENT INVOLVED (Mark all that apply)
1 Gity of Mesa Employee" Temporary Agency Workert*
Volunteer (Independent Contractor
Citizen O_ Otter:
‘Temporary Coordinator at (480) 644-2189 to confirm,
*DOT Post Accident testing may be required if employee or Temporary Agency Worker was performing DOT
covered activites. Contact Jackie Hale at (480) 644-4414 or by cell at (480) 387-0086 to confirm
“Temporary Agency Workers may be subject to drug testing by their employer. Contact Human Resources
CITY PERSON INVOLVED
‘Name: Philip Mitchell Brailsford
Employee ID #: 19861
HRM Department Superstition Patrol - Police HRM Group Code:572
‘Work Phone: x21 1 Cell Phone:
| Scheduled Work DaysiShift Tue, Wed, Thuriswings
O Stand-tn (Fire Dept.) CO Overtime
‘Scheduled Work Hours Start time: 1400
End time: 0000,
Page 1
6/29/2015City of Mesa Incident Report (continued)
CE nn eee et Seta telat Se
Incident Description
When providing details ofthe incident itis important to include information such as: 1) the activity you were performing
at the time of the incident; 2) any injury you sustained as a result ofthe incident; 3) how the incident and injury occurred;
and, 4) any damage to property and/or vehicles.
Officers were attempted to subdue/arrest criminals. The criminals fought with officers, Officer Brailsford grabbed
conto James Trevino to take him down. Officer Brailsford suffered minor scratching to his left arm. See Mesa Police
report 20152700672 for further details
Injury Was the City Person involved injured? (] Yes wo
Was medical treatment given? C] Yes [1 No, If Hospitalized ~ Hospital Name; NA
Describe medical treatment given; Refused
Refused
Injured Body Part (mark all that apply)
T Head OFot OR Ot[O eye OR Ol [OC Shouse OR OL
Back O Anke OR OL[O tes OR OL | Am ROL
T Othe Oknee OR GLO Wrst OR OL |OHend OR OL
OTHER PERSON INVOLVED
"Name: James Trevino Date of Birth:
‘Address
Celt Home: Work
Email address:
License Plate #: Year. Make Model:
If not Driver ~ Owner's Name (Owner Phone #
Incident Description
When providing details of the incident itis important to include information such as: 1) the activity you were performing
at the time of the incident; 2) any injury you sustained as a result ofthe incident; 3) how the incident and injury occurred;
‘and, 4) any damage to property and/or vehicles.
Officers were attempted to subdue/arrest criminals. The criminals fought with officers, Officer Brailsford grabbed
onto James Trevino to take him down. Officer Brailsford suffered minor scratching to his left arm. See Mesa Police
report 20182700672 for further details.
Injury “Was the Other Person involved injured? [] Yes (J) No
Was mecical treatment given? (Yes [1 No. if Hospitalized ~ Hospital Name:
Describe medical treatment given:
Page 2
6/29/2015WITNESS:
City of Mesa Incident Report (continued) _
(Winess Name
Email Address’
‘Address:
Home Phone:
‘Work Phone:
Cell Phone:
Witness Statement
SIGNATURES
Form Completed By:
Signature: SO Lf.
15-730
Mick Lic
Employee 1D #15 77&
(5? Date: _Y>2 5-1
SUPERVISOR (required)
Was a City employee/volunteer injured? Z Yes ONo
if so, was the injury to the City employee/volunteer preventable? Yes Wi No
Provide details on how preventability was determined or attach the Incident Investigation Report
Hf medical treatment was sought
‘+ Did the City Person go to the City's Directed Care facility, Banner Occupational Health Clinic?
0 Yes @ No
+ If Yes, please provide the following information
© Date/Time the City Person left the workplace or injury site to seek medical attention’
Date:
Time:
Olam Opm
© Have you adjusted, or notified your timekeeper to adjust, the employee's timecard to reflect Directed Care
48 required in the Directed Care Pay Policy?
+ Was the Employee mandated to seek medical treatment by his/her supervisor?
I Yes, who mandated treatment?
Supervisor Name: Nick Lien
‘Supervisor Signature: 7 a CSF b.
Cl Yes WJ No
© Does the Employee's timecard reflect the Directed Care Pay Code as required? [1 Yes @ No
i Yes ii No
Employee 1D #: 18730
9-26-15
ate:
6/29/2015,]
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ANTHL8S1 NE "S100 €MESA POLICE BASIC
TRAINING ACADEMY
TO: COMMANDER? LYTHGOE * 8908
FROM: — ofricer PHP meaugrom> #1930!
DATE: NOVEMBER 25, 2018
RE: VEST REIMBUESEMENT
sie,
LAM ANEW OFFICER PURCHAGING A NEW VEST REQUESTING FOR
A REIMBURSEMENT PLEASE,
RESPECT FULY,
OFFICER PHILIP BRAWSFORD™ Ite!BALLISTIC VEST REPLACEMENT FORM.
Name _? peausroap Employee Number_jat
RC Division/Assignment,
Circle One: Expired / Damaged KNew
Reason for replacement other than an expired warranty:
Member Signature: _“=?ZAZ.. hed Date: _/l-08-¢5
Commander Signature: Date:
*#***FOR FINANCIAL SERVICES USE ONLY******
Replacement Vest:
Manufacturer
Manufacture Date Purchase Date
Model Price
Serial Number_,3ui317453, Allowable
Amount
Threat Level
Difference
Lot # Amount
Date sent to
Vendor. Payroll
Accounting Code
IFP
DPM 1.0.65F1 REV o3/t8it3DR#20160180586
DR#20160180586
La Quinta Inn and Suites
6530 E. Superstition Springs Blvd Mesa, AZ
Room #502
Det. M. Rayburn #14211DR#20160180586
La Quinta Inn and Suites
5‘ Floor hallway and Room #502
(Overall)
Det. M. Rayburn #14211Placards
Det. M. Rayburn #14211
DR#20160180586
5" Floor Hallway
Evidence Identification Chart
Item#
Description
1221824 Fired Cartridge
1221825 Fired Cartridge
1221826 Fired Cartridge
1221827 Fired Cartridge
1221828 Fired Cartridge
1221829 Metal Projectile Fragment
1221830 Wrist Watch
None Women's Black leather purse
1221831 Metal Projectile Fragment
4221832 Metal Projectile Fragment
1221833 Metal Projectile Fragment
1221834 Metal Projectile Fragment
1221836 Metal Projectile Fragment
1221839 Metal Projectile Fragment
1221840 Metal Projectile Fragment
1221841 Metal Projectile Fragment
1221842 Metal Projectile Fragment
1221843 Metal Projectile Fragment
1221845 Metal Projectile Fragment
1221846 Metal Projectile Fragment
1221848 Wallet
1221850 Lighter
1221849 (Cell Phone
4221851 Metal Projectile Fragment
1221852 Metal Projectile FragmentR#20160180586
La Quinta Inn and Suites
(Hallway Measurements)
“matt |
Det. M. Rayburn #14211