Free F417-205-000 safety and health video library borrower agrement form - Washington


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State: Washington
Category: Government
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URL

http://www.lni.wa.gov/Forms/pdf/417205af.pdf

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Department of Labor & Industries Safety & Health Video Library PO Box 44607, Olympia, WA 98504-4607 Phone: 1-800-574-9881 FAX (360) 902-5675 Name Business Name

BORROWER AGREEMENT FORM Safety & Health Video Library
Format Preference VHS only DVD only Both, preference is VHS Phone Fax Email Address State Zip+4 Zip+4 Ship Only. DVD

To open an account and borrow videos, please fill out this form.

Type of Business City City

Physical Street Address (must be a Washington address) PO Box Number

WA
State

WA
Thurston County residents must pick up videos. Other users must designate Once the selection is made, it may not be changed.
TERMS AND CONDITIONS:

Pick Up Only

1. Copyrighted materials are loaned subject to the condition that any form of duplication is strictly prohibited in accordance with Title 17 of the United States Code of Federal Regulations. Unauthorized duplication of copyrighted materials will result in immediate cancellation of borrowing privileges. 2. Materials are loaned for a period of one week. When videos are borrowed, the shipping label has the return date printed on it. This is the date the videos must leave your office. Three late returns will result in immediate cancellation of borrowing privileges. Accounts may be suspended at any time for inappropriate use of resources. 3. Borrower accounts are established by individuals. There is no limit to accounts per business. However, a borrower may not loan materials to any person. Example of prohibited loans: consultant to client; corporate office to corporate office. You must return phone calls within 2 days. 4. The borrower is financially responsible for any loss or damage of library materials and agrees to reimburse the library for full recovery costs for any items lost or damaged. This may include the cost of videos, CDs, DVDs, printed materials, shipping cases, and collection costs. 5. The borrower is responsible for the cost of return shipping. Unless programs are hand-delivered by the borrower, return shipping must be through a TRACEABLE SHIPPING SERVICE e.g. United Parcel Service, Federal Express or Media Mail with Delivery Confirmation. Return by untraceable means will result in borrower liability in the event of loss and late return. Returning videos to an L & I Field Office or other facility is prohibited. 6. Accounts must be designated as Pick Up Only or Ship Only. Thurston County users are required to pick up and return materials to the L&I Service Location lobby in Tumwater. 7. I understand that costs due for lost or damaged items will be turned over to collections.
IMPORTANT: Read before signing
I have read and understand the terms and conditions listed on next page. As a condition of my participation in the Washington State Department of Labor & Industries, Safety and Health Video Library, I agree to comply with them. I have kept a copy of this agreement for my records. I certify that I am a Washington Resident.

Date

Signature (Library will issue a number) Borrower Account #

F417-205-000 safety & health video library agreement form 12-2007

See next page for more information

Safety & Health Video Library
Department of Labor & Industries

Library Policy
Videos must be returned on time.
Three late returns will result in immediate cancellation of borrowing privileges. You must return videos by traceable carrier. Also, please return phone call messages from us within two business days.

The Fine Print
If you or your shipper loses or damages a video or DVD you are responsible for their full replacement cost. When shipping by UPS or Fed Ex or some other commercial shippers your package is automatically insured for $100. You may want to purchase full coverage. Be aware that the average cost of each VHS or DVD is $500. If you choose to use the US POSTAL SERVICE, you may send by Media Mail with Delivery Confirmation. Purchasing insurance is recommended, but not required. Please use the PO BOX address: Department of Labor & Industries, Safety & Health Video Library PO Box 44607 Olympia, WA 98504-4607. Many employees of state agencies borrow videos from the Safety & Health Video Library. They, too, must use a traceable shipper to return videos.
You will be charged for items not returned.

"Only You"
Videos are checked out only to you. Don't loan them out. All transactions must be made through the Safety & Health Video Library.

Traceable Shipping Only
Your only cost is the return shipping by traceable carrier such as UPS or Fed Ex. Or if you prefer the US Postal Service, use Certified Mail only. Late videos must be shipped by guaranteed overnight delivery service. Return the package in an envelope or box.

Respect the Copyright
Unless specifically noted in the catalog and on the materials themselves, all library materials are fully protected by copyright under Title 17 of the United States Code of Federal Regulations.

Unauthorized duplication of copyrighted materials will result in immediate cancellation of borrowing privileges.

Library Procedures
One week loan
You can borrow up to five videos for 1 week.

Please be sure to rewind all videos, and to place each one correctly in its proper case. Videos can be easily damaged by being forced into cases backwards or upside-down. Protect videos from inclement weather during shipment.
We require you to reserve videos at least one week prior to your show date to allow time for shipping to any city out of the greater Olympia area.

Six Month Feature
You can schedule videos up to six months in advance.

Advance Notice
Please give us one week notice before you want to show videos. The videos will arrive 1-2 business days before your show date.

Thurston County residents must pick up and return videos in person. Allow at least two days for scheduling and one day for pick-up.

03-2007