Long Term Form - Page 1 of 2
(2nd page required)
Agreement No. (leave blank)
EQUIPMENT LOAN AGREEMENT
(Please read instructions on next page)
LENDING AGENCY OR INDIVIDUAL
DEPARTMENT RECEIVING LOAN
Name:
Department Name:
Address:
Contact Person:
Phone:
Phone:
Email:
Account/Fund No.:
EQUIPMENT IDENTIFICATION
Email:
(List separate items individually, even if they are components of an integrated
system. Attach separate sheet if necessary.)
Location
Room/Bldg
Description of each item
Cost/
Value
TRANSPORTATION PURPOSE OF LOAN
1)
Who will pay charges for transportation, including transit
insurance, to the campus or other location specified above?
 Lender
2)
 Demonstration
 Other (explain below)
 University
PERIOD OF LOAN
Who will pay charges for transportation, including transit
insurance, for return to lender?
 Lender
 Instruction
 Research
 University
From
Through
ADDITIONAL PROVISIONS (If any)
The Standard Terms of Equipment Loan (on next page) are hereby incorporated.
LENDER'S APPROVAL
I understand and agree that (1) the equipment identified above is loaned to the University under the terms and conditions described
above; (2) this agreement may be terminated at the request of either party; (3) University approval of this loan in no way constitutes a
commitment to purchase equipment at a later date.
Signature:
Name:
Title:
UNIVERSITY APPROVAL
Signature:
Name:
Department:
5/05
Signature:
Name/Title:
Department:
Bruce Porter, Director
Business Services & Contracts
After approval, copies to Lender, Department, Business Services & Contracts, Asset Management
Long Term Form - Page 2 of 2
(2nd page required)
INSTRUCTIONS TO UNIVERSITY DEPARTMENT
Use this form to document loans to the University from outside agencies or individuals (except agencies
of the federal government). For other types of loans, contact Business Services & Contracts at 2324.
1.
2.
3.
4.
5.
6.
Complete all portions of form.
Secure the signatures of the lender and the department head on all copies.
Send original to Business Services & Contracts, copies will be returned after approval.
INSURANCE INFORMATION: Property loaned to the University is not covered by the
University's Property Insurance Program. If the University is found to have caused damage or
loss of the loaned equipment, the end-user’s department may be held financially responsible for
replacement of equipment.
EXTENSION OR MODIFICATION OF LOAN AGREEMENT: Notify Business Services &
Contracts at Mail Stop 7474 of any modification of the terms stated on this form (i.e., extension
of the loan beyond the original time period).
The sale of any loaned equipment by the department is strictly prohibited by law unless specific
authority is granted in writing by the lender.
STANDARD TERMS OF EQUIPMENT LOAN
1.
2.
3.
4.
5/05
This agreement may be terminated by either party upon written notice to the other. Notice to the
University shall be delivered to Business Services & Contracts, 400 East University Way,
Ellensburg, WA 98926-7474.
University approval of this loan in no way constitutes a commitment to purchase the equipment
at a later date.
The University shall defend, indemnify and hold lender harmless from and against any and all
liability, loss, expense, attorneys' fees, or claims for injury or damages which are caused by or
result from the negligent or intentional acts or omissions of University, its officers, agents, or
employees.
Lender shall defend, indemnify and hold the University harmless from and against any and all
liability, loss, expense, attorneys' fees, or claims for injury or damages arising out of the
performance of this agreement but only in proportion to and to the extent such liability, loss,
expense, attorneys' fees, or claims for injury or damages which are caused by or result from the
negligent or intentional acts or omissions of Lender, its officers, agents, or employees.
This agreement constitutes the entire understanding between the parties respecting the subject
matter contained herein and supersedes any and all prior oral or written agreements respecting
such subject matter. No waiver, modification or addition to this agreement shall be binding
unless expressed in writing and signed by both parties.
After approval, copies to Lender, Department, Business Services & Contracts, Asset Management