Vehicle Rental Request Form

Facilities Maintenance & Operations

** AN APPROVED LENS CHECK IS REQUIRED **

(License Event Notification System)
PRIOR TO SUBMITTING THIS FORM!

Questions? Call 585-395-2408.

Vehicle Type Fleet Rental Rate Driver Requirements

Van (15 passenger) $85/day (includes unlimited gas) LENS and Van Driver Safety Training

Gem Car (2 seat) $30/day LENS
Vehicle Request Information:

● Submit one entry per vehicle.
● University-owned vehicles are limited to travel within the United States and to a driving distance within 10 hours of SUNY Brockport.
● Phone reservations are not accepted. This vehicle request form must be submitted to be considered for approval to reserve a university vehicle.
● Departures on holidays or weekends: Keys are available before 4:00 pm on the Friday before a holiday or weekend.
● Read more details at Vehicle Rental Procedures.
INFORMATION
Driver's Name Driver's Name First Last
Driver's Email
Cell Phone - Driver Cell Phone - Driver - ### - ### ####
Department
The selected department is the Arthur O Eve - E O P Program.

This department will not be charged for vehicle rentals.
The selected department is the Office of the President.

This department will not be charged for vehicle rentals.
Should anyone else be informed of the status of this request (in addition to the drivers)?

Should anyone else be informed of the status of this request (in addition to the drivers)? Yes No
Email - Additional contact
Driver status is
VEHICLE USE
Requested vehicle type

Requested vehicle type Van (15-passenger) @ $85/day GEM Car (2 seats) @ $30/day
Check the box to acknowledge that

Check the box to acknowledge that I have completed Van Driver Safety Training with the Environmental Health & Safety Office.
Length of time vehicle is needed

Minimum rental is ONE day.
Number of vans requested

Number of vans requested 1 2
Pickup Date Pickup Date / MM / DD YYYY
Pickup Time Pickup Time : HH MM AM/PM

Vehicle pickup time is M-F between 7am and 4 pm.
Return Date Return Date / MM / DD YYYY
Return Time Return Time : HH MM AM/PM

Use Key Dropbox in Lobby if returning after 4 PM.
Destination

For example, "Buffalo Zoo, Buffalo, NY"
Purpose of trip
Responsibilities of the Assigned Driver

The assigned driver is responsible for the vehicle, credit card, and E-Z pass during the approved rental period.
ALTERNATE DRIVERS
No other person is allowed to drive a state vehicle unless listed as an alternate driver and is:

● a SUNY Brockport employee (or approved volunteer)
● LENS valid
● Van Driver Safety Training Certified (if requesting a van)
Number of alternate drivers

Number of alternate drivers 0 1 2
It is the assigned driver’s responsibility to ensure that the alternate driver is approved to drive before allowing that person to drive the vehicle. Failure to adhere to this policy may result in the department’s forfeiture of future vehicle rentals.
Name - Alternate Driver 1
Email - Alternate Driver 1
Alternate Driver 1 is

Alternate Driver 1 is SUNY Brockport employee/approved volunteer LENS valid Van Driver Safety Training is current None of the above

select as many as apply
Name - Alternate Driver 2
Email - Alternate Driver 2
Alternate Driver 2 is

Alternate Driver 2 is SUNY Brockport employee/approved volunteer LENS valid Van Driver Safety Training is current None of the above

select as many as apply
Additional notes or comments regarding this request (optional)
Click on the "Continue" button to advance to the approvals page.

You can save your request by checking the box at the bottom of each page next to "Save my progress and resume later".
Save my progress and resume later
Enter Your Email Address *

A special link to resume the form will be sent to your email address.

Vehicle Type	Fleet Rental Rate	Driver Requirements
Van (15 passenger)	$85/day (includes unlimited gas)	LENS and Van Driver Safety Training
Gem Car (2 seat)	$30/day	LENS

Vehicle Rental Request Form

** AN APPROVED LENS CHECK IS REQUIRED **

Vehicle Request Information:

INFORMATION

The selected department is the Arthur O Eve - E O P Program.

The selected department is the Office of the President.

VEHICLE USE

Responsibilities of the Assigned Driver

ALTERNATE DRIVERS

No other person is allowed to drive a state vehicle unless listed as an alternate driver and is:

It is the assigned driver’s responsibility to ensure that the alternate driver is approved to drive before allowing that person to drive the vehicle. Failure to adhere to this policy may result in the department’s forfeiture of future vehicle rentals.

Click on the "Continue" button to advance to the approvals page.

AN APPROVED LENS CHECK IS REQUIRED