Equipment Responsibility Form

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Location
  Address

• Acknowledgement: I acknowledge that I have received the equipment listed below. I understand that it is my complete responsibility to keep the equipment in a safe place within work and I will not allow equipment to be accessed by any unauthorised personnel. I also understand that under no circumstances am I to lend this equipment to anyone without prior consent from a Senior Manager. I am aware that if the equipment is broken, stolen or damaged; it is my responsibility to immediately report to my Line Manager. I also understand that I may be charged for any damages that are incurred or if the item is lost or stolen whilst the equipment is in my possession due to misuse or carelessness. (This is based on method of damages). I understand that once my engagement ends with Lingwood Security Management, it is my responsibility to return all equipment that was signed out to me. Failure to do so will result in the full cost of the item(s) being deducted from my 􀏐inal pay. Should we be unable to collect the monies, please be advised the loss of costs for the equipment will be pursued for through a small claims court.

• NAME OF GUARD:

EQUIPMENT ISSUED:

• RADIO & SERIAL NUMBER

  Yes

  No

  N/A

• BODY CAM & SERIAL NUMBER

  Yes

  No

  N/A

• STAB VEST & VELCRO BADGES & SIZE (S/M/L/XL/2XL/3XL/4XL / 5XL)

  Yes

  No

  N/A

• SOFT SHELL JACKET & SIZE (S/M/L/XL/2XL/3XL/4XL / 5XL)

  Yes

  No

  N/A

• BLACK LSM POLO SHIRT

  Yes

  No

  N/A

• ID BADGE

  Yes

  No

  N/A

• BADGE HOLDER AND LSM LANYARD

  Yes

  No

  N/A

• SIGNATURE

  Sign

• PRINT

• LSM MANAGER

• PRINT

• DATE