Equipment Checklist - Download Now DOC by nzoRiV

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									     Checklist of Telecommuting Equipment, Supplies & Services
Place a check in front of the items needed for the proposed telecommuting situation and behind
the item indicate who will provide. Employee and his/her supervisor should work on this
together.
Electronics-Related
___ CPU/Modem         ___To be provided by employee      ___To be provided by department

___Printer            ___To be provided by employee      ___To be provided by department

___ Monitor           ___To be provided by employee      ___To be provided by department

___Software           ___To be provided by employee      ___To be provided by department

___Fax                ___To be provided by employee      ___To be provided by department

___Phone              ___To be provided by employee      ___To be provided by department

___Pager              ___To be provided by employee      ___To be provided by department

___Other_________ ___To be provided by employee          ___To be provided by department

___Other_________ ___To be provided by employee          ___To be provided by department

Furniture
___Desk               ___To be provided by employee      ___To be provided by department

___Credenza           ___To be provided by employee      ___To be provided by department

___Chair              ___To be provided by employee      ___To be provided by department

___Lockable Cabinet ___To be provided by employee        ___To be provided by department

___Bookcase           ___To be provided by employee      ___To be provided by department

___Other_________ ___To be provided by employee          ___To be provided by department

___Other_________ ___To be provided by employee          ___To be provided by department

Supplies
___Paper              ___To be provided by employee      ___To be provided by department

___Pens               ___To be provided by employee      ___To be provided by department
___Stapler            ___To be provided by employee      ___To be provided by department

___Tape Holder        ___To be provided by employee      ___To be provided by department

___Tape               ___To be provided by employee      ___To be provided by department

___Printer Cartridge ___To be provided by employee       ___To be provided by department

___Paper Punch        ___To be provided by employee      ___To be provided by department

___3-Ring Binders     ___To be provided by employee      ___To be provided by department

___Paper Folders      ___To be provided by employee      ___To be provided by department

___Stamps             ___To be provided by employee      ___To be provided by department

___Other_________ ___To be provided by employee          ___To be provided by department

___Other_________ ___To be provided by employee          ___To be provided by department

Services
___Extra Phone Line ___To be provided by employee        ___To be provided by department

___DSL Line           ___To be provided by employee      ___To be provided by department

___Voice Mail         ___To be provided by employee      ___To be provided by department

___Other_________ ___To be provided by employee          ___To be provided by department

___Other_________ ___To be provided by employee          ___To be provided by department

Other
___Wrist Pad          ___To be provided by employee      ___To be provided by department

___Cord Protector     ___To be provided by employee      ___To be provided by department

___Surge Protector    ___To be provided by employee      ___To be provided by department

___Other_________ ___To be provided by employee          ___To be provided by department

___Other_________ ___To be provided by employee          ___To be provided by department

Supervisor/Manager: After completing this checklist with the employee, see that the Receipt of
University Equipment/Supplies is completed in regard to all items both consumable and non-
consumable provided by the university.

								
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