Vehicle Rental Request

Please complete this form to request a rental vehicle from Georgia College Parking and Transportation Services. Feel free to contact us if you have any questions about the process. Parking and Transportation Services www.gcsu.edu/parkingandtransportation 478-445-7433 transportation@gcsu.edu - 330 West Thomas St. Milledgeville, GA 31061

Requestor's Name*

First & Last Name

GCSU Email*

Requestor's Work Phone*

Requestor's Cell Phone*

Department*

Payment Type*

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Account Number*

Number of Vehicles*

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Rental - Vehicle Type*

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Justification:

The State of Georgia travel policy requires a justification statement explaining the need for this vehicle.

Rental - Vehicle 2 Type*

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Rental - Vehicle 3 Type*

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Departure Date*

Departure Time*

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Return Date*

Return Time*

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Destination - Street Address*

Destination - City, State*

Destination - Meeting/Event Location Name

Rental - Purpose of Travel*

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Rental - Purpose of Travel Description*

Rental - Key Pickup Location (P&T ONLY)*

P&T Office @ NEW LOCATION - 330 West Thomas Street

Rental - MVUPDA*

Do you (or does the driver if the driver is not you) have a Motor Vehicle Use Program Driver Acknowledgement form on file with Human Resources for the current academic year, as required by GC in order to drive a rental vehicle? Please contact HR at 478-445-5596 to confirm if you are not sure. This form should be submitted to HR each year during annual compliance.

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Rental - WEX Fuel Card PIN*

Do you (or does the driver if the driver is not you) have an assigned and active WEX Fuel Card PIN, as required by GC in order use the rental vehicle's fuel card? If you do not have one or are unsure, please contact Materials Management at 478-445-5706. A PIN may have been deactivated if it has not been used in a while.

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Rental - Other Driver(s)*

Are you submitting this request on behalf of someone else who will be driving the vehicle?

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Rental - Name(s) of Other Driver(s)

Please include the names of the driver or any additional drivers here.

Additional Comments

Rental Fleet Acknowledgement*

I acknowledge the following while renting a university vehicle:

University vehicles are not to be taken or stored at personal residences during your rental.
The vehicle will only be used for university-related purposes.
Non-GCSU-affiliated passengers are prohibited.

Rental - Terms and Conditions*

By submitting this form, I agree that:

• THE VEHICLE WILL BE FUELED OR PLUGGED IN AFTER TRIP. Any vehicle not returned fueled will add administrative fees to the total charge.

• All trash will be removed from the rental vehicle upon completion of the trip. Vehicles returned in an unsatisfactory condition, may result in an additional fee.

• The vehicle keys will be returned to the P&T office upon trip completion. For after-hours, a key drop box is located on the porch.

• P&T will be notified no less than 24 hours from the scheduled departure if the trip needs to be rescheduled or canceled; failure to do so may result in the listed department being charged a cancellation fee for the rental vehicle.

• All other drivers of the rental vehicle for this trip will be notified of these terms and conditions

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