A.W. McClelland & Co. Vehicle Use Agreement
Complete this agreement with your manager, record vehicle details and condition, and e-sign to confirm you understand and will follow the rules.
Parties and Agreement Details
Employee full name
*
First Name
Middle Name
Last Name
Manager name
Please Select
Tim McClelland
Julie McClelland
Other
Other manager name
Agreement date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Vehicle allocation/start date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Vehicle Identification
Vehicle make
*
Vehicle model
*
Registration number
*
Registration expiry date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Odometer reading at handover
*
Vehicle Condition and Handover Items
Have any pre-existing damage or defects been recorded?
*
Yes
No
Damage or defect description
Damage or defect location and notes
Items issued at handover (select all that apply)
*
Keys
Supplied accessories
No items issued
Licence and lawful driving
*
I hold a current driver licence for the correct class and will promptly tell management about any expiry, suspension, cancellation, disqualification or restriction
I will only permit authorised drivers to drive the vehicle
I will obey all road and traffic laws
I will not use a handheld phone or text while driving
Fitness for driving
*
I will never drive when impaired by fatigue, alcohol, drugs, medication, or any medical condition that affects my ability to drive safely
I will not smoke or vape in the vehicle
Vehicle care
*
I will use reasonable care of the vehicle, keep it clean and secure, and take responsibility for its condition while in my custody
I will carry out routine checks and promptly report any defect, damage, or safety concern
I will service the vehicle as directed by management and comply with scheduled maintenance requirements
Accidents, costs and return
*
report accidents or incidents immediately, exchange required details, and do not admit liability or promise payment without authority
Fines and infringements are attributed to the responsible driver.
Fuel filled from the farm is covered by A.W. McClelland & Co.
Private use is permitted; fuel purchased away from the farm for private travel is generally paid for privately
return the vehicle, keys, cards and accessories when requested or employment ends
Condition evidence photos
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of
I have sighted the employee’s driver licence and checked its class and expiry date.
*
Yes
Driver Acknowledgements
Additional Requirements and Declarations
Additional vehicle requirements or comments
Employee declaration
*
I confirm the information provided is accurate
I understand and accept the vehicle use rules
I will report any changes promptly
Employee electronic signature
*
Employee date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Manager authorisation
*
Approved
Not approved
Manager electronic signature
*
Manager date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit
Submit
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