Rev.1/28/19
KeyRequest
FacilityServices
WO#_____________
Thisformistobecompletedbythebuildingcoordinator ONLY,signed,andattachedtoaFAMISWorkOrder.
NewEmployee
NewLock/Door
□
Lost
Stolen
Broken
□
Faculty
□
Staff
□
GraduateStudent
□
UndergraduateStudent
□
ExternalEmployee
RequestorInformation:
LastNameFirstName89Number
JobTitleLSUEmailAddressPhoneNumber
DepartmentAccountNumberDate
KeyInformation:
BuildingRoom# KeyCode Comments
BuildingRoom# KeyCode Comments
BuildingRoom# KeyCode Comments
Approval:
BuildingCoordinator(PrintedName)SignatureDate
Approval(RequiredforSubMastersandMasters):
Dean(AcademicArea)orDirector(NonAcademic)(PrintedName) SignatureDate
TonyLombardo
TonyLombardo,P.E.,FacilityandPropertyOversi ght SignatureDate
BartThompson
BartThompson,ChiefofPolice,LSUPDSignatureDate
IssuanceAgreement:
Iacknowledgereceiptoftheabovelistedkey(s)andadheretothe keycontrolpoliciesandproceduresaspertheUniversityRulesandRegulations:
A. Key(s)remainthepermanentpropertyofLouisianaStateUniversity.
B. Individualsmaynotloankeystoanyone.
C. OnlyanLSUlocksmithmayduplicate
LSUkey(s).
D. BuildingCoordinatorsaretheonlyauthorizedindividualstounlockdoors,andonlywhentheyarecertainthattheindividualisauthorized
tobeinthebuilding/room/area.
E. Uponterminationofemployment,orwhenachangeinspaceassignmentoccurs,key(s)mustbereturnedtoFacilityServices.Afeewill
bechargedforeachunreturnedkey,plusthecosttoreplaceeachcorethatthekeyoperates.(MasterKeyswillopenmultiplecores)
DuringperiodsofextendedleaveoraleaveofabsencefromtheUniversity,key(s)mustbereturnedtoFacilityServices.
F. Ifa keyislost
orstolen,theDepartmentHeadandLSUFacilityServicesmustbenotified.Also,apolicereportmustbefiledwithLSUPD
andacopyofthereportmustbeattachedtothe FS WorkOrder.
Signature(SignOnlyUponReceivingKeys)Date
Chrome Web Store
It looks like you haven't installed the Fill Chrome Extension Add to Chrome