Departmental Designated Authority Acknowledgement Agreement

Thompson Rivers University Fuel Card Agreement

Departmental ‘Designated Authority’ Acknowledgement Agreement

DEPARTMENT/FACULTY NAME: ______

I, ______(print name)as Designated Authority for the department or faculty named above hereby acknowledge the receipt of the Thompson Rivers University Fuel Card.

As departmental/Faculty designated authority I agree to protect the Fuel Card(s) assigned to me and ensure anyone using the card as a vehicle operator has signed this Acknowledgment Agreement, understands the card restriction and appropriate use of the Card

For security the card is not to be stored in the vehicle. I agree to return the Fuel Card to TRU at their request at any time.

Upon termination of employment I will immediately return the Fuel Card to the Purchasing Department, who will work withthe above mentioned Department to assign a new designated authority.

I understand that failure to promptly notify the Manager, and Purchasing of theft, loss or misplacement of the Fuel Card could make the Department/Faculty responsible for the cost of fraudulent use of the card. I also understand that the unauthorized use of this card may result in the immediate disciplinary action.

I have read and agree to abide by the terms and conditions and guidelines for the use of the Fuel Card provided to me by Thompson Rivers University.

Policy and Procedures

You will be provided with a monthly billing statement/invoice that lists all the charges made to your fuel card during the previous month. You are responsible for assuring that all the charges made to the fuel card are for your personal fleet vehicle(s), owned or leased by TRU. The Fuel Card remains the property of TRU and your right to use the card can be evoked by TRU at any time.

Your Fuel Card is as valuable as cash. Safeguard it against loss or theft.The magnetic strip is very sensitive and should not be left in sunlight or near magnetic materials.

Provide default budget accounting codes to allow gas charges to be applied directly. If you wish to transfer funds within your budget you will need to prepare an IDI to transfer funds after they are applied to your account.

Financial Budget Coding: FUND: ______ORG: ______ACCOUNT: ______

______

Card(s) holder Name (DA)Signature Date

______

Supervisor Name Signature Date

VEHICLE INFORMATION

Please use one form for each vehicle in your fleet (copy blank form as needed). Please print for clarity.

Vehicle Unit Number: ______Vehicle Registration #:______

Veh Make:______Model:______Year: ______last 4 # of Vin #: ______

Fuel Card users (Vehicle Operators): All persons using this vehicle must sign below that they understand and will comply with the designed usage of the PHH card and program.

1______

Name Signature Date

2______

Name Signature Date

3______

Name Signature Date

4______

Name Signature Date

5______

Name Signature Date

6______

Name Signature Date

7______

Name Signature Date

8______

Name Signature Date

9______

Name Signature Date

At a glance rules of theFuel Card (blue card) usage.

1)Protect the ‘blue card’ from misuse or loss

2)Do not store the ‘blue card’ in the vehicle

3)The vehicle log book is to remain in the vehicle, be maintained accurately and stats are to be recorded for each business journey and when the vehicle is fuelled

4)The ‘blue card’ is the property of TRU and PHH. Upon request or upon expiry of employment with TRU the ‘blue card’ is to be return to TRU

5)Notify TRU of loss or misplacement of the ‘blue card’ immediately.

6)Each ‘blue card’ is registered to one vehicle. (1 vehicle = 1 card) Do not use a ‘blue card for another vehicle

7)Misuse or fraudulent use can result in immediate disciplinary action.

• Questions on Fuel Card ‘blue card’ program contact Purchasing: 250-371-5757
• Questions on environmental stats and log book upkeep contact Environment: 250-852-1799