Mad-tool / Equipment Loan Out Checklist

LIABILITY RELEASE

By signing this document you hereby release the loaning company from any and all legal liability resulting from the use of the loaned equipment or tools. The undersigned also agrees to provide the proper safety training prior to the use of any of the equipment or tools noted below.

TOOL / EQUIPMENT INFO

Select tool or equipment being loaned:

Hand tool
Power tool
Ladder
Scissor Lift
Fork Lift
Other

Have we verified that all operators are trained and currently certified in according with 29 CFR 1910.178(l)? (Certification information must include name of operator, date of training, date of evaluation, and identity of trainer/evaluator). Certification is valid for up to 3 years.

Fork lift will be returned in same condition it was received INCLUDING FUEL LEVEL.

Take a picture of the training documentation.

Enter tool / equipment name:

BORROWING COMPANY

Name of borrowing company:

Name of person:

Signature:

Date loaned out:

Mad-tool / Equipment Loan Out Checklist

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