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    Default Equipment release form verbiage

    I'm drawing up a new equipment release form.

    I listed the equipment, serial #, condition, etc....

    I want to have a quick little paragraph above their signature on the bottom of the form to have the person acknowledge that they have received the equipment, are responsible for the upkeep of the equipment, and are responsible for replacement of equipment that is either lost or destroyed by other means than normal use. Doesn't have to be a long paragraph or complicated.

    Anyone want to offer any suggestions?
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    Here is something I quickly came up with:


    I, the undersigned, hereby acknowledge I have received the above listed equipment and I am responsible for the upkeep of the equipment. I understand that I may be responsible for the replacement of equipment that is lost or damaged by abnormal use.
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    Heres how ours reads...you can use whatever wording from it however you may want to.

    ----------------------------------------------------------------------
    Release of Liability Consent
    (For used equipment)

    ___________(Recipient) holds the Bridge Canyon Vol. Fire Dept harmless for the reciept of the equipment described below.

    This equipment has been recieved by the Recipient with the full understanding that it is being delivered "AS IS,WHERE IS".
    The Recipient also acknowledges that the Bridge Canyob Vol.Fire Dept. is not or does not claim to be a dealer or merchant of said equipment, and that the Recipient is relying on no representations or warranties made by the Bridge Canyon Vol. Fire Dept in its decision to take title to or possession of said equipment.Said equipment is being accepted by the Recipient WITHOUT any warranties,EXPRESS OR IMPLIED,ANY WARRANTY OF MERCHANTIBILITY,OR ANY WARRANTY OF FITNESS FOR A PARTICULAR PURPOSE.

    Recipient understands that the Bridge Canyon Vol. Fire Dept. will have no control over the use of said equipment while in the possession of the Recipient or at anytime thereof, and consequently,the Bridge Canyon Vol. Fire Dept shall not have any resposibility or liability for its use.

    The Recipient agrees to idemnify the Bridge Canyon Vol.Fire Dept for any loss and/or damage to person and/or property that may arise from the use of said equipment,by the Recipient,or anyone or anything thereof,and further warrants that Recipient will provide liability insurance on the equipment in the emaount of not less than $ _____.

    The Bridge Canyon Vol.Fire Dept. will not be held responsible or liable in ANY case for damages and/or injury that may result or incuured to result from the use,or misuse,of said equipment.The Recipient agrees that it shall be solely responsible in complying with all OSHA standards,NFPA standards or any other standards that may exist,if any exist,on the use of such equipment and further acknowledge that the Bridge Canyon Vol.Fire Dept. makes no warranties or representations as to whether said equipment meets,or may in the future meet such standards as may be applicable.

    ADDITIONAL COMMENTS: _______________________________________________

    ITEM MAKE MODEL S/N FD S/N

    ___________________ _________ _________ ________ __________
    ___________________ _________ _________ ________ __________
    ___________________ _________ _________ ________ __________
    ___________________ _________ _________ ________ __________
    ___________________ _________ _________ ________ __________


    METHOD OF RECIEPT: (circle one)

    SALE or LEASE: Make payable to: Bridge Canyon Vol.Fire Dept Amount Paid: $_______

    LOAN or GIFT:
    DISPOSAL:
    OTHER:

    Chief or Administrative Assistant: ____________________Date__________

    Recieved by/Consent to Release(Recipient) _____________Date__________

    Recipients PRINTED Name: _____________________Date__________

    By: ___________________________________________Date___ _______


    Board Consent: By _______________________; ATTEST: By _______________
    (Chairperson) (Clerk)

    ----------------------------------------------------------------------


    Good Luck!

    Donna C
    Fire Chief
    Bridge Canyon VFD
    http://cms.firehouse.com/dept/SeligmanAZ

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    I, the undersigned, hereby acknowledge I have received the above listed equipment and I am responsible for the upkeep of the equipment. I understand that I may be responsible for the replacement of equipment that is lost or damaged by abnormal use
    I, the undersigned, hereby acknowledge I have received the above listed equipment.I acknowledge I am responsible for the maitenece of the above listed equipment. I acknowledge that I may be responsible for the replacement and/or repair of the above listed equipment that is lost,stolen or damaged through accident or misuse.

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    Adze

    Many Departments have different forms to sign for receipt of equipment. What you have written sounds fine.
    "The uniform is supposed to say something about you. You get it for nothing, but it comes with a history, so do the right thing when you're in it."
    Battalion Chief Ed Schoales
    from 'Report from Ground Zero' pg 149
    I.A.C.O.J. Member

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    Originally posted by July36
    The Recipient agrees that it shall be solely responsible in complying with all OSHA standards,NFPA standards or any other standards that may exist,if any exist,on the use of such equipment and further acknowledge that the Bridge Canyon Vol.Fire Dept. makes no warranties or representations as to whether said equipment meets,or may in the future meet such standards as may be applicable.
    If I were a volunteer, I don't think I could sign something like that. To me, it sounds like you guys are issuing equipment and saying "good luck" to your firefighters... God help them if anything goes wrong because it sounds like your release form says the FD isn't responsible for much -- if anything.

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    Aww you know--OSHA -- NFPA- ect --just abunch of "stupid standards"

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    I think ur missing the point COZMOSIS...
    According to our attorneys,which were the ones that wrote this release form up,stated that that is the best way to go...in our particular predicament.We simply cannot afford the possible lawsuits that may arise from releasing old equipment and when ur donating equipment...you should not have any kind of responsibility of it once it leaves your hands...and any GOOD attorney will tell you this.
    Futhermore,we do not force the recipient or whomever to take the equipment or sign anything...that entirely is up to them...but to "save" our @$$ from lawsuits...then if they want the equipment then they must sign.
    I take it that apparently you either would WANT the lawsuits OR youd be the type that would not help other 'needy' companies because of the lawsuits.
    Its really sad that the politics is sooooo bad that we have to do whatever it takes,whether it be right or not,to protect ourselves from these lawsuits.
    It is not us that is forcing the equipment onto the recipient...it is the recipient that WANTS the equipment.
    It should not be our fault if something happens to the recipient or causes damages or whatever once it is out of our possession so think about what you said one more time and think about it really closely.

    Donna C
    Fire Chief
    Bridge Canyon VFD
    http://cms.firehouse.com/dept/SeligmanAZ

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    Your right SLACK...most of it IS nothing more than a bunch of stupid standards BUT....most of it is there in wording just to make the "politicians" and the legal system happy. LOL

    Donna C
    Fire Chief
    Bridge Canyon VFD
    http://cms.firehouse.com/dept/SeligmanAZ

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    July36, that form is for when you are donating/selling your used equipment?

    What about when you issue your equipment to your personnel?
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    Originally posted by July36
    I think ur missing the point COZMOSIS...
    It's possible. Is the release form you posted for use when donating equipment to other departments? Or for when you are issuing gear to firefighters? I think Adze was looking for the latter... and I was under that impression that that's what your post was addressing.

    Fire departments should be responsible for any and all gear issued to their own firefighters. No firefighter should have to sign away his rights to be a member. However, if your release form was for donated gear... I can see where your attorneys are coming from and don't really have a problem with your release.

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    Adze -
    Are you looking at this from the point of view of say an equipment officer who is issuing PPE to personnel??

    Or do you mean an equipment release form for someone who is outside the FD - who is borrowing equipment from the FD?

    If you are talking about PPE -- well its going to have some wear and tear.

    What you have sounds OK. Not all the manufacturers have the same info - gloves for example. Your turnouts probably have a serial #- but I doubt you'll find them in a pair of gloves or on a hood.... Aside from listing the equipment, and what condition that it was recieved in (NEW,USED-Good,USED-Fair, etc...) what you have sounds good.

    Might mention 'serviceabliity' -- jeez that was the catch phrase in the Corps. Let the people know that they are responsible for the equipment - as best as they can maintain it - but also they are responsible for letting the Equipment/Supply Officer know when an item is "becoming" unserviceable - so that a replacement can be ordered in time - as not all equipment is maintained on hand.

    You mention abnormal use... I would say - use in a manner other than what it is intended for. Screwdriver vice prybar. Hammer vice Spanner. I know that emergencies are our line of work - but I know alot of guys that pick the wrong tool for the job and destroy them.

    Might also mention training - you know - correlate a level of training to the type of equipment that a person is receiving. Are they qualified with an SCBA - if not - why give them a facepiece?

    dunno -- hope this helps...
    Marc

    "In Omnia Paratus"

    Member - IACOJ
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    -- The opinions presented here are my own; and are not those of any organization that I belong to, or work for.

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    This for is for Scott masks and voice amplifiers that are going to be issued to the personnel. All are numbered and we do expect some sort of wear and tear.
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    Very good question ADZE and COZMOSIS....and thanks for bringing that up for clarification...

    This particular form is for any old "joe" that comes in wanting old equipment.

    The equipment we issue our firefighters we DO take full responsibility on.We will not issue our fire/medical personnell any equipment that we cannot take full coverage on.

    Actually for our firefighters,we have no forms other than one that they sign saying that they were issued the equipment.This form has the information of the firefighter as well as the information of the equipment we are issuing(similiar to our release form but without all the legalities).We do this simply because should a firefighter move away...and our equipment happens to go with him or her...then we have all the info we may need in attempting to retrieve the equipment.We started doing this becuase of an incident that happened awhile back before we "logged" any of the equipment issued.
    One of our firefighters took off with all of the company issued stuff..including the radio,and there was no way we could retrieve any of it becuase we had no "proof",even though we knew it was our "issued stuff"...so we decided to start "logging" everything simply because we cannot afford the replacements.

    Donna c
    Fire chief
    Bridge Canyon VFD
    http://cms.firehouse.com/dept/SeligmanAZ

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    I forgot to add something...to ADZE.
    What you have written sounds fine with me.On ours we have the firefighter "sign out" the equipment...with no kind of "catches" like is in our general public release form...and if and should the firefighter leave..he then must sign the equipment back in upon final departure of our department.However,our equipment release form DOES state that it is expected to be taken care of,less the normal wear and tear that is to be expected and that misuse of such equipment cannot be tolerated.
    I will scan or write out a copy of our release form to firefighters and post in here soon.

    Donna C
    Fire Chief
    Bridge Canyon VFD
    http://cms.firehouse.com/dept/SeligmanAZ

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