Occidental College Authorized Driver Application (Page 2 of 2) in pdf

Occidental College Authorized Driver Application Page 2

NORTH ORANGE COUNTY COMMUNITY COLLEGE DISTRICT

FACULTY/STAFF, STUDENT AND VOLUNTEER DRIVER INFORMATION

RELEASE AND AGREEMENT

9. In the event of an accident resulting in property damage and/or bodily injury, I shall immediately make a report to

the local law enforcement agency and I will not leave the scene of the accident until I have been directed to do so

by law enforcement official.

10. In the event an accident occurs while using a private vehicle on District business, I understand that the private

vehicle insurance policy is primary per the California Vehicle Code. A concurrent report must be made to the

private insurance company and the District Risk Manger.

11. I understand that the use of a District vehicle is for District business only and I agree not to use this vehicle for my

personal business at any time, including periods when participating in out-of-town/state field trips. I understand

that violation of this agreement may terminate my permissive vehicle user status and compromise my liability

coverage through the District.

12. I give my permission to allow the District or its agent to obtain my motor vehicle record from the California

Department of Motor Vehicles at any time.

I have read the forgoing and I am fully aware of the legal consequences of signing this Release and Travel Waiver

Agreement and I hereby voluntarily agree to the terms that are stated above. I hereby voluntarily sign this form.

Volunteer Driver Signature

Date

District Signature

Date

To be completed by Site Coordinator: Date of Vehicle Return

_________________ Initials:________________

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Occidental College Authorized Driver Application Page 2