Equipment Loan Form
This form provides guidelines for borrowing equipment from Berkeley City
College. Before removing equipment or furniture from the premises an employee
must have written approval from their supervisor.
Part A Loan Details
Lender Information:
Department Name:______________________________________________________________
Borrower and Equipment Information:
Borrower:__________________________________Phone Number:________________________
Address:________________________________________________________________________
Loan Period:
From:______________________________To:____________________________________
Equipment Details: (use additional pages as needed)
PCCD Asset Tag Number
Description of Item
Serial Number
Equipment Security (Please check each box):
____ I confirm that I will keep equipment, especially technology equipment, secure at all times.
____ I confirm that I will return the equipment in the condition in which it was received.
Unit Approval:
________________________________________________________________________________
Signature Printed Name/Title Date
Part A Routing Instructions:
1. Copy to Unit Supervisor
2. Copy to Business Office (Attention: John Pang)
click to sign
signature
click to edit
Equipment Loan Form
Part B Returning Loaned Equipment
The portion of the form is to be filled out when equipment has been returned to Berkeley City
College. If the equipment is not returning to the college at the conclusion of the loan, please
contact your supervisor.
Unit Verification:
I hereby confirm that the equipment listed have been returned to Berkeley City College.
_____________________________ ______________________________ ________________
Employee Signature Printed Name Date
_____________________________ _______________________________ ________________
Supervisor Signature Printed Name/Title Date
Part B Routing Instructions:
1. Original: To Supervisor
2. Copy : To Business Office
click to sign
signature
click to edit
click to sign
signature
click to edit