REQUEST FOR USE OF SAINT JOSEPH'S UNIVERSITY VEHICLE

Requestor: Tel # :
Department:
 
Department Head Authorization:

(sign here)

 
Budget Number: - -
Destination:
Address:
Purpose:
Number of People Transporting:
Departure Date: Departure Time(AM/PM):
Return Date: Return Time(AM/PM):
Driver's Name: Driver's License:
Saint .Joseph's University's ID. Number:

THIS FORM MUST BE SUBMITTED VIA FAX TO x3019 AT LEAST 24 HOURS IN ADVANCE. YOU WILL GET AN E-MAIL CONFIRMATION ONCE FORM IS RECEIVED. NO VAN WILL BE RELEASED WITHOUT CONFIRMATION. PHONE REQUESTS WILL NOT BE ACCEPTED. THE AUTHORIZED USE OF THIS VEHICLE IS FOR THE STATED PURPOSE AND THERE WILL BE A CHARGE TO THE ABOVE BUDGET NUMBER OF $25.00 FOR THE FIRST DAY ONLY, AND FIFTY CENTS ($0.50) PER MILE PER IRS REGULATION FOR VAN USE. VEHICLES ARE TO BE USED FOR SJU EVENTS ONLY; NOT FOR NON-SJU STUDENTS. WHEN PICKING UP THE VAN, THE DRIVER MUST BE 19 YEARS OF AGE AND PROVIDE A VALID DRIVER'S LICENSE, A VALID SJU CERTIFIED DRIVER TRAINING CERTIFICATE AND A VALID SJU IDENTIFICATION CARD. NO OTHER FORMS OR IDENTIFICATION WILL BE ACCEPTED.VEHICLES MUST BE BACK BY "RETURN TIME" STATED ABOVE WITH A CLEAN INTERIOR. KEYS MUST BE PICKED UP AND RETURNED TO THE FACILITIES MANAGEMENT OFFICE, MOORE HALL ROOM 110, BETWEEN 7:00AM AND 4:30 PM. EACH VAN CAN TRANSPORT A MAXIMUN OF 12 PASSENGERS PLUS THE DRIVER. THE DRIVER WILL BE RESPONSIBLE FOR ALL LIQUID LEVELS - GASOLINE, OIL, ANTI-FREEZ, ETC. FOR ASSIGNED VEHICLE.

I acknowledge and understand these regulations.
Signature: Date:

SEAT BELTS MUST BE WORN - NO EXCEPTIONS

Departure(miles): Return(miles):
Assigned Vehicle: Actual Mileage:
Hours: Cost($):
Remarks:
Fill in Form Then Print Page
Fax signed Approval form to Facilities Management at X3019

Loading...