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The undersigned borrower and undersigned users hereby certify to the following:

1. I am a resident of the City of Chandler and I am over the age of 16.

2. Neither my spouse, or I are employed by the City of Chandler.

3. I have received instruction on the operation and maintenance of the items listed in Section II of this form.

4. I will operate any equipment listed in Section II of this form in a manner instructed by the staff of the City of Chandler.

5. I will return the items listed in Section II of this form no later

than _______________am/pm on____________________

6. I will only allow the persons who have signed below as borrower or user to use the items.

7. The items listed in Section II are dangerous to children 16 years of age and under and I will present any such children from having access to the items.

8. I will not use the items listed in Section II of this form for commercial purposes. Additionally, I will return the items to the located listed in Section II in a clean and working manner.

9. While transporting any equipment listed in Section II, I will secure it in a manner, which will prevent it from falling from my vehicle. WE CURRENTLY HAVE A CITY VOLUNTEER THAT WILL

10. I understand that the use of the equipment listed in Section II is dangerous and can result in injury or death and I agree to indemnify, defend and hold harmless the City of Chandler, its Mayor and Council, appointed boards and commissions, officials, officers, employees individually and collectively, from all losses, claims, suits, actions, payments and judgments, demands, expenses, attorneys fees, defense cost, or actions of any kind and nature resulting from personal injury to any person, except any such injury or damages arising out of the sole negligence of the City, its officers, agents or employees.
Last Updated: 24 May 2007 15:11:37 PDT home  |  about  |  terms  |  contact
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