Fillable Printable Monthly Parker Agreement Form - Colorado

Monthly Parker Agreement Form - Colorado

MONTHLY PARKER AGREEMENT--GME

(Please Print)

Last Name: First Name: Employee ID# Date:

Email Address:

CIDEX NUMBER ( - - )

First 4 letters of last name - MMDD of DOB - Last 4 of Social

Vehicle Information (REQUIRED): (Must include License Plate Numbers to process form)

STATE LICENSE PLATE #: MAKE MODEL YEAR COLOR

Terms and Conditions:

I hereby certify that this information is true and agree to the terms and conditions herein and the rules and procedures on the reverse.

Customer Signature: Date:

*Form must be fully completed in order to be accepted by parking office

Signature of Parking Office employee completing form: ___________________________________ Date:

___________________

GME OFFICE USE ONLY:

Check one:

VA Only (No fee required) AMC Only ($10 fee required)

BOTH VA/AMC ($10 fee required)

PARKING OFFICE USE: (CHECK OFF ONLY WHEN PROCESS IS COMPLETED)

Amount Paid: $ Permit or Card Number: _______________________________

Comments: _______________________________________________________________________________________

Parking Agreement

This agreement is made between the "Customer" listed on reverse and The University of Colorado Anschutz Medical

Campus and Standard Parking. As part of this agreement, the customer who parks with the University and Standard

Parking agrees to all conditions of the agreement.

Accounts in Department Billing:

The parking access device or hang tag will be operational when the authorized Customer delegate sends via

fax or mail, on department letterhead, the following information for the employee(s): (1) Name(s), and (2) effective

date authorizing the employee(s) to park under the departmental account. The letter must be signed by an

authorized individual in the department.

All Accounts:

The customer agrees to pay a one-time, non-refundable $10 activation fee that is charged for all new

accounts and for any parking accounts that have been inactive for six consecutive months. The Customer agrees

to pay for their parking access and the amount of monthly parking. Payment is due on the first of the month. If

payment is not received by the fifteenth day of the month, their parking access or hang tag may be deactivated or

unauthorized and the parking Customer(s) will have to pay the normal daily rate and/or parking citation amount

upon exiting. Any Parking Access hang tag that is lost, stolen or returned damaged will be subject to a $10 Non-

Refundable replacement fee.

The Customer agrees to provide the University/Standard Parking with any changes for the account on a timely basis.

All vehicle information must be kept current by contacting the Parking Office at 303-724-2555.

Only authorized parkers will be allowed to park. Cars parked in handicapped stalls must display a valid handicapped

permit. If a vehicle needs to be left unattended for more than two (2) days, the Customer must notify the Parking

Office. Vehicles without prior approval may be ticketed or removed from the facility at the owner's expense. I

understand that the entry card or permit is issued exclusively for my use. No one else will be allowed to use my

entry card and/or permit at any time.

The Customer will be charged for parking as long as they are assigned parking access privileges.

This agreement may be cancelled with a notice and the return of the access card and or hang tag. The

notice may

be faxed, mailed or hand delivered to our office. It is the Customer's responsibility to ensure that the

University/Standard Parking is in receipt of the cancellation.

The Customer (and its employees) acknowledge(s) and agree(s) that the University and Standard Parking shall not be

responsible or liable for the loss of or damage to vehicles or articles of personal property left in vehicles parked in

the parking facility. Each vehicle is parked at the parker's risk.

There will be an administrative fee charged for all returned checks. In the event the Customer is in default, the

Customer agrees to pay all costs of collections and attorney fees with interest. The signature on this agreement

acknowledges that the Customer (and its employees) have read, understand and agree to all of the above terms

and conditions. There are no outside conditions, verbal agreements or understandings.

No refunds or credit will be given for absence, vacation or other non-use of parking under this

agreement.

I acknowledge that I have received a copy of the "Most Commonly Asked Questions".