Authorization for Move Form (Office/Lab)

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THIS FORM MUST BE COMPLETED BY THE UBM OR DEPARTMENT HEAD

UNIVERSITY OF LOUISVILLE DEPARTMENT AUTHORIZING MOVE:

Department Name (Required)

Person Authorizing this Move (Required)

Billing Address (Required)

Contact (Required)

Phone (Required)

Check One (Required) Office
Lab

If Lab, Employee Name

Requested Date of Move (Required)

MOVING FROM:

Building, Floor, Room # (Required)

Street (Required)

City, State, Zip (Required)

LOCATION MOVING TO:

Building, Floor, Room # (Required)

Street (Required)

City, State, Zip (Required)

LOCAL OR INTRASTATE MOVES:

Each shipment relocated by Berger Transfer Storage, Inc. receives $100,000 of free insurance. However, if this move is a local move, and your lab/office/furniture/equipment is moving more than 100 feet from the building you are located in, you must contact Sandy Russell in U of L Insurance and Risk Management at 852-4652 to purchase additional insurance sufficient to cover the goods you are moving. You are responsible for making sure the goods are ensured by Insurance & Risk Management.

Speedtype(s) to be charged for this move (Required)

List of Unusual or Heavy Items

Personal tools

Authorization for Move Form (Office/Lab)

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