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This is an agreement between the Cole County/Jefferson City Emergency Management Agency Lender and the borrower (submit name below) for use of equipment (submit kind/type below) from the date(s) (specified below).
Equipment Use Authorization Form and FEMA 213RR must be completed and signed for equipment use before taking possession of the property.
Borrower Name
Borrower Email Address
Check any all items you are requesting from the list above.
Please provide details as to additional equipment not in the list above that you are requesting.
Under the normal exchange of equipment both parties agree that the individual assigned to operate the equipment must be trained on the operation of and recognizes the hazards of the equipment. Borrower will have a certificate of insurance and adequate insurance to cover damages.
The borrowing agency shall indemnify and hold harmless Cole County to the fullest extent permitted by the laws of the State of Missouri in effect at the time against and in respect of any and all actions, suits, proceedings, claims, demands, judgments, costs, expenses (including advancement of reasonable attorney’s fees), losses, and damages resulting from Burrowers good faith performance of duties and obligations with the Cole County.
The borrowed equipment must be returned to the owner in the condition it was received. The borrower is responsible for all reasonable repairs including parts and labor should malfunction or damage occur during the borrowing period. Inspection of equipment is encouraged before taking possession. Equipment use authorization form must be completed and signed before taking possession of the equipment.
Borrowing party is responsible for all liability, losses, damages, costs or expenses which arise out of the negligent act or omission of the equipment user while acting in the course of their involvement with the above mentioned agreement.
For normal exchange of vehicles or equipment, a minimum of seven working days’ notice must be given to the lender prior to expected date of use. All completed and authorized documents must be received by the lender two days prior to the expected date of use. Equipment use is for a 24 hour period. Extensions may be granted by appropriate personnel.
In the event of an emergency in which there is an identified need for the retrieval of equipment to respond to such an emergency, property will be retrieved by lender at little to no notice.
By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
Signature, Title, Agency, Date
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