1 Start 2 Complete CONTRACTOR PARKING PERMIT APPLICATION A UNIVERSITY REPRESENTATIVE MANAGING A PROJECT MUST COMPLETE THIS SECTION. IMPORTANT: Applications will not be processed without this section filled out COMPLETELY, and signed. DATE RANGE OF PROJECT FROM: * Year Year20182019202020212022 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 TO: * Year Year20182019202020212022 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 UVM DEPARTMENT MANAGING PROJECT * UVM DEPARTMENT REPRESENTATIVE * Signature: * Phone Number (Direct Line) * LOCATION OF PROJECT * DESCRIPTION OF PROJECT * Please select Contractor or Subcontractor * - Select -ContractorSubcontractor PLEASE CHECK ONE * UVM DEPARTMENT CHART STRING WILL COVER PARKING PERMIT COSTS (YOU MUST ADD A CHART STRING BELOW) CONTRACTOR WILL COVER PARKING PERMIT COST Chart String, if department is paying * Type in N/A if CONTRACTOR will be covering the parking cost. COMPANY INFORMATION Company Name * Street Address * City * State * - Select -AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMexicoMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUS GovernmentUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaOntarioPrince Edward IslandQuebecSaskatchewanCommonwealth N. Mariana IslandsCosenza (Italy)Delhi (India)Minas Gerais (Brazil)New South Wales (Australia)Oaxaca (Mexico)Punjabi Bagh (India)Rio de Janeiro (Brazil)Victoria (Australia) Company Contact Name * Phone Number * Email * Permit - PLEASE SELECT ONE PERMIT TYPEIMPORTANT: Final decision on the permit type issued will be made by Transportation and Parking Services based on availability of space and number of active permits currently assigned to the vendor/contractor making the request. Brown Permit $165 yr $21 mo White Permit $247 yr $31 mo Green Permit $329 yr $41 mo Occasional Use Permit Brown $2 day White $3 day Green $4 day Please Review Carefully Before Signing I understand I am responsible to know and comply with University's Parking Rules and Regulations as well as the process of appeals for citations incurred. I understand the assigned parking permit is for the sole use of the individual to whom it is registered and cannot be resold, photocopied, altered or remanufactured and is not transferable to any individual or any vehicle other than those registered with UVM Transportation and Parking Services. I understand all vehicles must display a valid permit at all times while parked on campus to avoid violation. I understand I am responsible for all parking citations issued to any vehicle while conducting business on our behalf and all citations not eligible for appeal must be paid in full before any parking permits are issued. NOTE: THIS SIGNATURE WILL BE USED AS PROOF OF AGREEMENT TO THE TERMS ABOVE IN ANY SUBSEQUENT PARKING PERMIT PURCHASE DURING THE PERMIT CYCLE WHERE A SIGNATURE MAY NOT BE OBTAINED. The University of Vermont assumes no responsibility for damages to, theft from, or theft of any vehicle parked on University property. Motor vehicle accidents that occur in the UVM campus should be reported to Police Service. Signature * Date * Year Year20182019202020212022 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 CAPTCHAThis question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Math question * 2 + 14 = Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.