2.1 Employee(s) filling-in while the position is vacant

  Weekly salary rate:

$

Number of weeks:

Sub-Total: 

$

 2.2 Lost productivity of fill-in employee

Percent of weekly salary rate:

Number of weeks:

Sub-Total: 

$

 2.3 Conducting an exit interview

 Hourly salary rate of employee:

Hourly salary rate of interviewer:

Number of hours:

Sub-Total: 

$

 2.4 Manager's time

Hourly salary rate:

Number of hours:

Sub-Total: 

$

 2.5 Training provided to departing employee

Cost of training:

Cost of licenses/certifications:

Sub-Total: 

$

 2.6 Lost departmental productivity

Percent of average weekly salary rate:

Number of weeks:

Number of employees:

Sub-Total: 

$

 2.7 Severance and benefits continuation

Weekly salary rate:

Four weeks on average:

Sub-Total: 

$

 2.8 Lost knowledge, skills and contacts

50% of Annual salary rate:

50%(+10% for every additonal year of service):

Sub-Total: 

$

 2.9 Separation administrative functions

Hourly salary rate:

Number of hours:

Sub-Total: 

$

 2.10 Decreased employee productivity

Weekly salary rate:

Number of weeks:

Sub-Total:

 2.11 Minus the savings in salary for departing employee

Weekly salary rate:

$

Number of weeks:

Sub-Total:

$

Total: 

$