Fillable REQUEST FOR USE OF MOTOR VEHICLES (Rogers State University)

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REQUEST FOR USE OF MOTOR VEHICLES (Rogers State University)

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REQUEST FOR USE OF MOTOR VEHICLES
Date of Request:
Name of Person(s) to Travel:
Give Destination and Purpose of Trip:
Driver's Certification: For my protection and the protection of my department, I agree to inspect the vehicle(s) assigned
to me BEFORE I leave the parking lot. If I notice any damage or problem with the vehicle, I will have a Physical Plant
employee make a note of the damage BEFORE leaving the lot and retain a copy for my department.
VEHICLE REQUEST REVISED 1/2021 - KK
Dates of Travel:
Hour of Departure: __________AM __________PM Hour of Return: __________AM __________PM
Type/Number of Vehicle(s) Requested: __________________
Types of Vehicles:
Cars: 5 person maximum |
Minivans: 7 person maximum |
Passenger Vans: 10 person
maximum |
Bus #54: 24 Passengers |
Bus #47: 37 Passengers |
Rate: $0.560
Rate: $0.560
Rate: $0.720
Rate: $1.760
Rate: $1.760
Department:
Account Number:
Department Head Approval
Date
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REQUEST FOR USE OF MOTOR VEHICLES (Rogers State University)

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Completed 9 February 2021

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