Employee MetroRail / Tri-Rail Pass Election Form

Employee MetroRail / Tri-Rail Pass Election Form

(PUBLIC TRANSIT PROGRAM INCLUDES METRORAIL, METRO BUSES, MIAMI-DADE "PARK & RIDE" EXPRESS BUSES, AND TRI-RAIL)

WE ORDER TRANSIT PASSES IN ADVANCE! THEREFORE, THIS FORM (AND APPLICABLE PAYMENT) MUST BE SUBMITTED BY THE 14TH OF THE MONTH. TO RECEIVE A PASS IN THE SUBSEQUENT MONTH.

After submitting this form, you will receive an e-mail to acknowledge this request.

( * ) Asterisks indicate required fields.

University of Miami Email Address:*

Must be a Valid University of Miami Email Address.

@med.miami.edu, @miami.edu or @umiami.edu

Re-enter Email Address:*

Must be a Valid University of Miami Email Address.

@med.miami.edu, @miami.edu or @umiami.edu

Employee ID#:*

C# or Workday ID

First Name:*

Middle Initial:

Last Name:*

Department:

Preferred Phone:

Phone

🚨 INVALID EMAIL ADDRESS ENTERED! 🚨

If you submit this request, it WILL be automatically cancelled. Please double-check and enter a valid University of Miami email.

@med.miami.edu, @miami.edu or @umiami.edu

ONLY FULL-TIME FACULTY AND STAFF WITH BENEFITS ARE ELIGIBLE FOR DISCOUNTED PASSES THROUGH PAYROLL DEDUCTION. TEMPORARY, PER DIEM STAFF, AND OTHER EMPLOYEES WITHOUT BENEFITS MAY PURCHASE TRANSIT PASSES AT THE FULL PRICE LISTED UNDER THE $70,001 OR MORE SALARY RANGE.

Salary Range Selection*

Select

Salary $35,000 or Less*

$20.65 - Metro Rail Pass Only

$31.90 - Metro Rail Pass with Parking

$10.00 - Tri-Rail Only - ***

$45.00 - Tri-Rail w/Regional Pass ***

Salary $35,001 - $40,000*

$35.65 - Metro Rail Pass Only

$46.90 - Metro Rail Pass with Parking

$33.50 - Tri-Rail Only ***

$71.75 - Tri-Rail w/Regional Pass ***

Salary $40,001 - $45,000*

$50.65 - Metro Rail Pass Only

$61.90 - Metro Rail Pass with Parking

$48.50 - Tri-Rail Only ***

$86.75 - Tri-Rail w/Regional Pass***

Salary $45,001 - $50,000*

$65.65 - Metro Rail Pass Only

$76.90 - Metro Rail Pass with Parking

$63.50 - Tri-Rail Only ***

$101.75 - Tri-Rail w/Regional Pass ***

Salary $50.001 - $70,000*

$80.65 - Metro Rail Pass Only

$91.90 - Metro Rail Pass with Parking

$78.50 - Tri-Rail Only ***

$116.75- Tri-Rail w/Regional Pass ***

Salary $70,001 or More*

$95.65 - Metro Rail Pass Only

$106.90 - Metro Rail Pass with Parking

$93.50 - Tri-Rail Only ***

$131.75 - Tri-Rail w/Regional Pass ***

Do you currently hold a Corporate Easy Card?*

Yes

Corporate Easy Card #*

Tri-Rail Only

**For Tri-Rail passes, you must obtain an EDP (Employee Discount Program) EASY card.

Go to www.tri-rail.com > select Fares > Employees > Select link to complete EDP Application > Complete the application.
In the “Choose Employer” section in the drop down menu select “University of Miami”.
Submit your application using your UM e-mail address.

Once you receive your card, enter the EDP # and card # in the fields below. You must have your EDP card in order to ride Tri-Rail.

EDP Card #*

(6 digits on back of card)

Card #*

(Card # - 20 digit serial number on back of card)

Employees with Benefits:

I authorize the University of Miami to deduct the above amount from my paycheck each month on a pre-tax basis until I submit cancellation form by the due date stated in the University of Miami's Public Transit Program policy. I understand the University will evaluate my salary periodically and adjust the deduction amount as required.*

** Temporary, per diem staff and other employees without benefits must pay by credit card or check each month before the deadline.

I agree to the terms of the University of Miami Public Transit policy and understand that violations will result in disciplinary action up to and including possible termination and/or prosecution.

In summary, selling, sharing, or giving transit passes to others is forbidden, reduced fare passes must be used as your primary means of commuting to work, and you may not have a campus parking permit and reduced fare transit pass at the same time.

Employees and students interested in the public transportation program must read and comply with the provision of the Public Transit Program policy.

Signature*

Public Safety Administration Office

1501 NW 9th Ave. Suite 100 Miami, FL. 33136

Office: (305) 243-6280 (2)

Email: ppasses@miami.edu

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