INFORMATION TECHNOLOGY

Bio-Rad Smartphone Eligibility Request Form

Bio-Rad will offer employees who need to access Bio-Rad data or be reached when away from their offices a company-
provided mobile device. Bio-Rad grants employees the choice to purchase and use pre-approved personnel devices under
limited circumstances. Bio-Rad’s standard device for a company-provided smartphone is the Apple iPhone. (devices based
on availability) For additional information please see Mobile Device Policy 412.P Rev. 2. This global policy applies to Bio-
Rad employees and must be approved with the following conditions below:

 Business justification for smartphone eligibility based on the eligibility guidelines below
 Manager, Division manager and HR Representative approval
 Mobile Guidelines signed by the device user

If you received this form from a self-service request email for Mobile Device ordering, please scan and reply back to the
email you received with this form attached. If you received this form from the Service Desk, please contact the service
desk and have this form to provide to the Service Desk Agent.
Requestor Information

Name of Device User

Last First M.I.

Email Address:

Manager Name: Dept #:

Division Manager:

HR Representative:

Business Justification for Request

Please place an X in the box for the appropriate eligibility role: Please see Page 2 for description of the Job Roles

Job Role
Senior Managers
Frequent Travelers
Employee in Sales Management and other Sales Role
Employee in Service Roles
Customer Facing Support Staff
On-call personnel (e.g. Facilities, Manufacturing, Operations)
Personnel responsible to support global Bio-Rad teams
Non-exempt personnel in roles requiring them to be working in off-hours**
Additional Information: (examples – choose carrier (Verizon or T-Mobile), request area code, port phone number, use personally owned device.)

Request Approval
Approval Signatures required.
Requestor: Please fill out the form with your manager, division manager and division HR representative approval.

Department Manager: Date:

Division Manager: Date:

Division HR Representative: Date:

Document Number: Revision: 1.0 Document Approval Number:

Effective Date: 06/4/2014 Page 1 of 2

 INFORMATION TECHNOLOGY

Bio-Rad Smartphone Eligibility Request Form

Job Role Description

Senior Managers Bio-Rad Management PC Grade 61 (US Grade 12) or above

Frequent Travelers Employees who make five or more intercontinental business

Employees in Sales
Management and other
Sales Roles
Employees in Service Roles
trips per year
Person whose role is directly related to the sale of Bio-Rad
products: eg: Sales Representative, Key Account Manager,
Capital Sales Specialist
Person who services Bio-Rad products on customer premises

Customer Facing Support Person whose predominate role requirement (75% or more of
Staf the time), is for immediate and mobile response to external
customers (Product Specialist, Product Manager)

On-call personnel (e.g. Person whose predominate job requirements, (75% or more of
Facilities, Manufacturing, the time), is for immediate and mobile response to on-call
Operations) duties related to business continuity

Personnel responsible to Person whose role requires providing internal services with a
support global Bio-Rad global scope (e.g. HR, Global ERP & IT).
teams

Document Number: Revision: 1.0 Document Approval Number:

Effective Date: 06/4/2014 Page 2 of 2