INSTRUCTIONS: A representative of either the employer or the employee organization may file a Notice to Negotiate. Pursuant to Ohio Revised Code Section 4117.14, this notice is filed by (check one) the employer or the employee organization. This document is to be sent to SERB and the other party electronically in read only format. A party lacking the capability for electronic service may file a motion for relief from electronic filing requirements pursuant to OAC 4117-02(F).1. Name of E m ployer:

Address: Telephone: ( )

City, County, State, Zip: Email :

2. Name of Employer’s Representative:

Address: Telephone: ( )

City, State, Zip: Email :

3. Name of Employee Organization & Parent Organization Affiliation (if any):

Address: Telephone: ( )

City, State, Zip: Email :

4. Name of Employee Organization’s Representative:

Address: Telephone: ( )

City, State, Zip: Email :

5. Bargaining Unit Certification:

□Board-Certified Unit (Describe unit or attach copy of current recognition clause)

□Deemed-Certified Unit (Describe unit or attach copy of current recognition clause)

6. Approximate Number ofEmployees in Unit:

7. Does the initiating party propose multi-unit bargaining? ____Yes ____No If yes, please identify other unit(s):

ERB1014 Page 1 of 2

Mediation Case No.

NOTICE TO NEGOTIATE (File a separate Notice for each bargaining unit)

State of Ohio State Employment Relations Board 65 East State Street, 12th Floor Columbus, Ohio 43215-4213 (614) 644-8573 MED@SERB.ohio.gov

Revised (5/18)

Notice to Negotiate (ERB 1014 - 5/18)8. Collective Bargaining Agreement: Are the employee organization and the employer currently parties to a collectivebargaining agreement? ____Yes ____No

If yes, state expiration date: (1) of agreement ___________ (2) of extension ____________ (if any)

Is this regarding negotiations for a REOPENER of the collective bargaining agreement? ____Yes ____No

If yes, designate: (1) date on which negotiation period ends: ___________

(2) section of re-opener provision: ___________ (attach copy of provision)

9. Mutually agreed upon Dispute Settlement Procedure: Have the parties adopted a mutually agreed uponnegotiations dispute settlement procedure that supersedes or deviates from the statutory procedures set forth in Ohio Revised Code Section 4117.14? (Note: Grievance procedures are not negotiations dispute settlement procedures.)

____Yes ____No

(a) If there is a negotiations dispute settlement procedure in the bargaining agreement, designate section: ____________ (b) Attach a copy of the procedure.

DECLARATION

I declare that I have read the contents of this Notice to Negotiate and that the statements it contains are true and correct to the best of my knowledge and belief. An exact copy of the current collective bargaining agreement (check one):

□is attached

□is on file with SERB

Signature of Person Confirming the Content of Form Date

Print or Type Name

THIS NOTICE TO NEGOTIATE WILL NOT BE ACCEPTED FOR FILING IF THE PROOF OF SERVICE IS NOT FULLY COMPLETED AND SIGNED BY A REPRESENTATIVE OF THE INITIATING PARTY.

PROOF OF ELECTRONIC SERVICE

I certify that an exact copy of the foregoing Notice to Negotiate has been sent electronically to:

(Name, complete address, and email address of other party to negotiations) Sent via electronic mail at approximately: ________________ (time)

this _________________(day) of ______________________________________(month),___________________(year).

Signature of Person Confirming Service of Form Print or Type Name

Page 2 of 2

State Employment Relations Board

Instructions for completing the Notice to Negotiate (NTN) Form

Box: Information Requested

1 Name of Employer - Fill in complete name, address, phone number, and email address.

2 Name of Employer’s Representative - Fill in complete name, address, & phone number of the person representing the employer, including an email address.

3 Name of Employee Organization & Parent Organization Affiliation (if any) - Fill in complete name, address, & phone number of the employee organization including an email address.

4 Name of Employee Organization’s Rep - Fill in complete name, address, & phone number of the person representing the employee organization, including an email address.

5 Bargaining Unit Certification Board Certified - Describe unit or attach a copy of current recognition clause from contract or certification. Deemed Certified - Attach a copy of current recognition clause from contract.

6 Approximate Number of Employees in Unit – Provide number of employees in bargaining unit.

7 Does the initiating party propose multi-unit bargaining? – Answer question and describe the other bargaining unit(s) (if applicable).

8 Collective Bargaining Agreement – Are the employee organization and employer parties to a collective bargaining agreement? If yes, list the expiration date of (1) agreement or (2) section of re-opener agreement (if any). If No, check mark.

If negotiations are for a re-opener designate (1) date on which negotiations period ends, (2) section of re-opener provision (if any). If no, just check mark.

9 Mutually agreed upon Dispute Settlement Procedure (MAD) – Identify if the parties have adopted a mutually agreed upon negotiations dispute settlement procedure that supersedes or deviates from the statutory procedures set forth in Ohio Revised Code Section 4117.14?

Note: Grievance Procedures are not negotiations dispute settlement procedures.

Declaration – Requires the signature and printed name of the person confirming that the information provided is true to the best of their knowledge and must include the date.

Proof of Electronic Service – The person filing the Notice to Negotiate must sign and print name confirming that an exact copy of the Notice to Negotiate was delivered electronically to the employer representative / employee organization representative (the other party). The person filing the Notice to Negotiate signs the bottom line of the form.

Note: The Notice to Negotiate will not be accepted if the Proof of Electronic Service is not fully completed and signed by a representative of the initiating party.

COMPLETION CHECKLIST

Did you remember to:

Provide accurate email addresses.

Completely fill in the Proof of ElectronicService.

Submit by email: Email: MED@SERB.ohio.gov