DAYS & HOURS OF ACCESS:
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College Hours 6:00 a.m. – 10:30 p.m. – 7 Days
| Unlimited – 24 hours/ 7 days Limited Access (list below): | | | | | | | | |

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Limited Access:
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- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Issuance of Access Card - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
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I understand and agree that the access card issued upon approval of this request is the property of the College and I further acknowledge responsibility and accountability for the card. I will report loss or theft of the card to Central Control Access Administrator in the Campus Police Department immediately and to my department head. I also understand that the access card is issued for my exclusive use and may not be duplicated, loaned or used to allow any unauthorized person into a controlled area. I further understand and agree that my full cooperation will be expected during any investigation concerning a security matter that might have occurred in a controlled facility during a time when my presence in the facility has been recorded by the system. I further agree to remain knowledgeable of and abide by the College’s Controlled Access policy while in possession of the card, and I understand that any violations of this policy may result in revocation of access card use and/or disciplinary action.
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Employee’s Signature:
| ______________________________________________ | Date: __________________ | | | | | | |
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Approved:
| _____________________________ | ________ | _____________________________ | ______ | | | | | |
| | | Division/Department Head
| | | Date | | Executive Dean/Vice Chancellor | | Date | | | |
| | | | | | | | | | (as applicable)
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| | | _____________________________
| ________ | _____________________________ | ______ | | | | | |
| | | Department Access Control Manager
| Date | | Central Access Control Administrator | Date | | | | | |
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- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Replacement Card Issued - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
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I acknowledge receipt of replacement access card and the payment of $10.00 replacement fee.
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Employee’s Signature:
| _________________________________________ | | Date: _________________ | | | | | |
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Approval Signature:
| _________________________________________ | | Date: _________________ | | | | | |
| | | | Division/Department Head
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Form 1370/002 (11/17)
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