Property Management Policy & Procedure Manual
Section 000: Introductory Material
This agreement is used when property is loaned to OSU. The completed agreement and signed exclusions page should be forwarded to Property Management. If the property will be in OSU’s custody for more than 90 days and is to be insured by OSU, a completed Fixed Asset Data Entry (FADE) form should be attached as well.
To Be Completed By Lender:
To Be Completed By OSU:
Listing of Object(s) on Loan:
TO BE COMPLETED BY LENDER:
Address:1450 NW Grant Ave.,Corvallis, OR 97330
Telephone: (541) 752-7722
Date Object(s) will arrive at OSU: 01/05/02
Date Object(s) will be removed: 05/31/02
Title of Exhibit (if any):__________________________________
Name & Telephone number of LENDER’S Insurance Co.
State Farm Insurance Co., (541) 758-6767
Will LENDER’S Insurance Company cover object(s)?
Yes:___________ No: X .
TO BE COMPLETED BY OSU:
Address 104 Peavy Hall
Telephone: (541) 737-4047
Contact Person: Eileen Gibby
Is insurance to be provided to OSU? Yes X No __
If yes, explain what direct or material benefit will accrue to OSU by the loan of this object(s). If personal property is being loaned to OSU for on-the-job use by LENDER, explain why OSU does not provide the equipment.
Equipment is not available within the department and is only needed for a short term project.
LISTING OF OBJECT(S) ON LOAN:
Description / Manufacturer / Model Serial or ID No. Value Condition on Arrival at OSU
Cassette Recorder, Mitsubishi HS-U54, s/n U54009188M____$499.00___________Good_________
_Camera, Olympus 35mm SLR, s/n N/A___________________$250.00___________Good_________
Examined by:___Eileen Gibby_____________ Title:_Office Specialist II Date:__01/03/02____
LENDER has read the Department of General Services, Policy Manual, “Exclusions” to insurance provided by OSU and understands what is not covered. The parties have caused this Agreement to be executed as of the date of the last signature.
____Ellen Helmrick____________01/03/02 _______________________________________
NOTE: If OSU agrees to provide insurance, agreement must be signed by OSU Property Management. Send to Property, Contract & Risk Management, 644 SW 13th Street, Corvallis, OR 97333-4238). Direct questions to Property Management at 737-7350.