Written Acknowledgment — Policy Non-Compliance (2nd Occurrence)
Policy Non-Compliance Escalation Framework (Independent Contractors)
Use this template when escalating a 2nd occurrence of policy non-compliance. Complete the Ops sections, send to team member to fill their sections, then obtain both signatures and store in the Policy Compliance Tracker.
Name: _________________________________________
Date: _________________________________________
Role/position: _________________________________________
Brief explanation on Policy Violated
(Completed by Operations / People Ops)
Policy name: [e.g. OOO Policy]
Requirement: [One-sentence requirement, e.g. “OOO requests must be submitted at least 2 weeks prior to the first day of absence.”]
On [date/context], the above requirement was not met. This is the second occurrence documented for this policy under our escalation framework.
Policy reference: [Link to policy page in Operations Manual]
Effect of Non-Compliance
(Completed by Operations / People Ops)
[Neutral statement, e.g. “Repeated non-compliance may be considered in decisions regarding contract renewal, assignment to new projects, and client-facing responsibilities. Documentation supports consistent application of contractual expectations.”]
Next step/Action
(Leave blank — to be filled out by Team member)
Acknowledgment + Confirmation statement
(To be completed by Team member)
I acknowledge receipt of this Written Acknowledgment and understand the [Policy name] requirement. I confirm my commitment to comply with this policy going forward.
Signature (Team member): _________________________ Date: _________
Counter signature (Manager / Ops / People Ops): _________________________ Date: _________