Utah State University New Vehicle Worksheet

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Utah State University
New Vehicle Worksheet
Policy Statement: In accordance with rules and policy set forth by the Utah State Legislature and enforced by the State of Utah Fleet
Division the following criteria will be followed when purchasing or replacing a University vehicle: 1) The size of USU's Fleet cannot be
increased without special legislative approval; therefore, before a leased, new or used vehicle is added to the fleet, the requesting
department must first identify and declare surplus on an exisiting vehicle. 2) No passenger vans larger than a minivan are allowed. 3)
Appropriate and readily available safety equipment shall be included with each vehicle. 4) All vehicle purchases will be reviewed for
right-size (smallest and most efficient) vehicle application along with safety features.
General Information
Date Submitted:______________ Department: ______________________________________
Contact Person: _______________________________________________________________
Email: __________________________ Phone: _____________ Cell Phone: _______________
Surplus Information
Vehicle Being Replaced: Year:_______ Make: _____________ Model: __________________
License #: ______________________ Inventory #: ___________________________________
Surplus Disposal Record #: _________________________________________
Federal Surplus Vehicle?
Yes
No (Contact Federal Surplus Contact if Unsure)
Right-Size Vehicle and Purchase Information
Vehicle Being Purchased:
New
Used
Year: ___________ Type: _______________ PO#: __________________________________
Cost: ________________ Banner Index # for Gas Card and Repairs: _____________________
Right-Size Justification:
HB110 requires all state vehicles to be the smallest size and most fuel efficient possible. Hybrid and
alternative fuel vehicles are preferred whenever possible. Please justify any vehicle purchase that is not a
small sedan, pickup or hybrid type and why it is necessay to purchase this vehicle:
Primary Operator's Signature: __________________________________ Date: ___________
Dean/Dept Head's Signature:
Date: ___________
New Vehicle Information
USU Vehicle #: __________________ Date Entered: ________________________________
Year: _________ Make: _____________ Model: __________________ Color: _____________
Inventory #: ______________ VIN: ________________________________________________
Mileage: _________________ Primary Operator: ___________________________________
Inspection Due: _____________ Fuel Type(s): ______________________________________
License Plate # : ____________________________ MPG: Hi ___________ Lo ____________
Additional Operators: __________________________________________________________
This form may be saved onto your computer and attached to an email.
Please return this form to Marsha Howell (marsha.howell@usu.edu)

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