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Environmental Health, Safety & Risk
E H & S
TEL NO: (818) 677-2401
FAX NO: (818) 677-5853
MAIL DROP: 8284
Driver Verification Form
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Acknowledgement and Verification

 

I hereby acknowledge that I have read and understand the policies and procedures outlined in the Vehicle Usage Policy.

The undersigned further agrees to comply with the policies and procedures as set forth in the Vehicle Usage Policy.

Failure to comply with these policies and procedures could result in the loss of my privilege to operate a university or private vehicle while on official state business.

This verification is freely and voluntarily disclosed.

 

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Employee Signature: ______________________________________________

Date: _________________