Physical Plant Management	PPM TEL NO: (818) 677-2222 FAX NO: (818) 677-4883 MAIL DROP: 8291
	Motor Vehicle Purchase Approval Form

I.	REQUESTER:	DEPARTMENT:	EXT/FAX:	MAIL DROP:	EMAIL:
II.	DESCRIBE REQUESTED VEHICLE:

CHECK ONE:		NEW VEHICLE REQUEST		Used vehicle request (inspection must be made by campus vehicle Inspector)
CHECK ONE:		VEHICLE WILL BE AN ADDITION TO THE CAMPUS VEHICLE INVENTORY (Will not replace an existing vehicle).		VEHICLE WILL REPLACE AN EXISTING VEHICLE (existing vehicle will be disposed of)

III.	IF THE REQUESTED VEHICLE WILL BE AN ADDITION TO THE CURRENT CAMPUS INVENTORY, DESCRIBE: (USE SEPARATE PAGE IF NECESSARY)
	1. WHY WAS AN ADDITIONAL VEHICLE NEEDED? 2. WHERE THE VEHICLE WILL BE SECURED AND STORED.

IV.	IF THE VEHICLE WILL REPLACE AN EXISTING VEHICLE. DESCRIBE: (USE SEPARATE PAGE IF NECESSARY)
	1. THE VEHICLE TO BE REPLACED, (Make, model, year, manufacturer's ID number (VIN), mileage, vehicle license # and present day location) 2. THE PLANNED DISPOSITION OF THE VEHICLE, (e.g. to be sold at auction)

V.	REQUESTING DEPT/UNIT APPROVALS:

SIGNATURE: _______________________

TITLE: _________________________

DATE: _______

SIGNATURE: _______________________

TITLE: _________________________

DATE: _______

VI.	VICE PRESIDENT FOR ADMINISTRATION AND FINANCE: I SUPPORT PURCHASE OF THE REQUESTED VEHICLE AND UNDERSTAND THE REQUESTING DEPARTMENT WILL BE OBLIGATED TO FUND OPERATIONAL AND MAINTENANCE COSTS, INCLUDING INSURANCE, VEHICLE SAFETY MODIFICATIONS, AND STORAGE EXPENSES AS NECESSARY.

SIGNATURE: _________________________________________________

DATE: _______

VII.	CAMPUS APPROVALS:
ALL VEHICLE REQUESTS:		SAFETY APPROVAL:*
DIRECTOR OF PHYSICAL PLANT MANAGEMENT		DIRECTOR OF ENVIRONMENTAL HEALTH & SAFETY
SIGNATURE: ____________________________		SIGNATURE: _______________________________
DATE: _______		DATE: _______

*(Only required for heavy machinery vehicle such as forklifts, tractors, street sweepers, etc.)