JURUPA UNIFIED SCHOOL DISTRICT Barbeque Rental Form

							                                JURUPA UNIFIED SCHOOL DISTRICT
                                                Barbeque Rental Form
School Site:                                                                            Date of Request:

Contact Person:                                                                          Date Required:

Phone Number:

Program to be Charged:

Requestor's Signature:




   Barbeques must be cleaned by your site, prior to returning them to the Central
  Stores/Receiving Warehouse, or there will be a $50.00 cleaning fee for each unit.
                      This cost will be charged to your site!

    Barbeques can be rented for $100.00 a day, per barbeque. Please send the completed form to the
           Central Stores/Receiving Warehouse, with a copy to Food Services. Thank you!


                                                                                                                   District Office to
                                                                                           Charge                     Complete

1. Barbeque                                     Please Check ($100)                              $100.00

2. Additional Barbeque                          Please Check (If applies) ($100)                 $100.00

3. Cleaning Fee                                 Please Check (If applies) ($50)                   $50.00




                                                                                              Subtotal:


                                                                                                    Total:




_________________________________                                                  ___________________
Request Approved by CSR                                                            Date



I hereby acknowledge receipt of the equipment listed above.                        Equipment listed above has been returned to CSR.



________________________                    ___________                            _______________________                   ___________
Requestor's Signature                            Date                              Authorized Signature                           Date