Smartphone/ Work Phone Loan Agreement
Please fill out the following form if you have been provided with a smartphone for work purposes while working as an Independent Contractor with CW & A, LLC.
Device Description:
IMEI, MAC Address, Color
Make & Model/ Model Number
Samsung Galaxy A02 = Make: Samsung & Model: SM-A022F
Includes?
USB Charging Cable
Power Adapter
Other
Accessories (Cases, Stylus, etc.)
Purpose
Loaned To:
Full Name
First Name
Last Name
E-mail
Phone Number
-
Area Code
Phone Number
Date of Agreement
/
Month
/
Day
Year
Date Picker Icon
Renew Agreement or Return Device by
-
Month
-
Day
Year
Date
Please initial next to each of the following statements to show that you understand and agree to each term/ condition
I understand that I am responsible for returning the equipment listed above in the condition in which it was received and I willingly take responsibility to make certain that it is returned in the same condition. I accept financial responsibility for any repairs or replacement of lost or damaged items.
I understand that I have been allowed to use this device for the period of time stated above and that this device is to be intended to be utilized for business purposes only.
I understand and agree to answer this device in the event Chris Wade should need to contact me unless extenuating circumstances exist.
I understand that the use and possession of this device is a privilege that can be revoked at ANY TIME and for ANY REASON.
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