E3512
Business and Non-Instructional Operations
Equipment Loan Form

I assume the responsibility for the following District equipment:









Purpose (not for personal use):









I have contacted my homeowner's insurance carrier and have been assured
that this equipment will be covered for loss or damage while it is under
my control. If it is damaged, I will pay the cost of repairs.
I will return the above equipment to
Administrator/designee
no later than .


Signed:
Date:
Approved:
Date:
Adopted: 9/10/97
Revised: