SOP 215.14-att-2: Authorization for Use of Company Vehicle by Resident

Division:
Facilities
Effective Date:
January 6, 2022
Reference Code:
IID04-0012
Topic Area:
215 Policy-Transitional Center
PowerDMS:
View on PowerDMS
Length:
131 words

Summary

This form documents requests for transitional center residents to operate company vehicles during employment, including trips to and from the workplace during scheduled working hours. The form requires justification for the request, detailed vehicle information, insurance coverage details, and approval from the facility superintendent. Completed forms are maintained in the resident's case file according to standard retention schedules.

Key Topics

  • vehicle use authorization
  • company vehicle
  • resident employment
  • transitional center
  • work release
  • vehicle operation
  • superintendent approval
  • resident case file
  • employment duties

Full Text

SOP 215.14
Attachment 2

01/06/22

# Authorization for Use of Company Vehicle by Resident

This is a request for ________________________________ to use a company vehicle during
Resident’s Full Name

the course of employment with ____________________________. This vehicle may also
Full Name of Company

be driven to and from the place of employment, during regularly scheduled working hours, in

the performance of his/her employment duties, while residing at _______________________.

Center Name

Justification For Request:
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________

Type of Vehicle to be Operated:

__________________________________________________________________________
Make Model VIN #
__________________________________________________________________________
Description
__________________________________________________________________________
Frequency of Use
__________________________________________________________________________
Type and Amount of Insurance Coverage

Name of Company Employee making Requesting: _______________________________

_____________________________________ ____________________
Signature of Company Employee Date

_____________________________________ ____________________
Approval/Disapproval of Superintendent Date
(circle one)

Retention Schedule: Upon completion, this form shall be placed in the Resident’s case file and maintained according
to the official retention schedule for that file.

Attachments (2)

  1. Waiver of Liability (123 words)
  2. Authorization for Use of Company Vehicle by Resident (131 words)
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