Contractor Less Than 30 Day/Roof Access

Contractor Less Than 30 Day/Roof Access Forms Combined

Lock Shop’s Contractor form with approvals and key agreement upload

"*" indicates required fields

Name of person completing this form*

First Last

Project Name*

Company Name

Company Representative Name*

First Last

Unity ID (If applicable)

Ex: Beginning of NCSU Email

Badge Number*

Ex: 000111222

Company Address

Street Address Address Line 2 City State ZIP Code

Company Phone*

Company Email*

Need to add another company?*

Yes

Company #2 Information

Representative Name*

First Last

Company Address*

Street Address Address Line 2 City State ZIP Code

Company Phone*

Company Email*

Badge Number*

Ex: 000111222

Need to add a third company?*

Yes

Company #3 Information

Representative Name*

First Last

Company Address*

Street Address Address Line 2 City State ZIP Code

Company Phone*

Company Email*

Badge Number*

Ex: 000111222

Project Details

List all buildings and keys where access is needed.*

Example: “Sullivan I Bldg keys and mechanical keys, Zone 2 roof, etc.”

Is badge access required?*

Yes

List all buildings you need badge access for*

Is roof access required?*

Yes

Project start date*

Project completion date*

ROOF ACCESS FORM

The section must be completed for key access to roof in specified areas.

NCSU Project Manager Name*

First Last

Company Name*

Company Representative Name*

First Last

Company Phone*

Project Manager Name/University Affiliate*

Date of Project*

Zone and Building?*

Acknowledgement of Key Checkout and Roof Access Terms and Conditions

When the person completing this form uploads the Construction Key Request Liability Acknowledgement Record, the form will be routed to the Director for approval. After the Director approves, the person completing this form will receive an additional email asking for final approval of terms. The Lock Shop Supervisor will THEN approve/deny Roof Access.

Upload liability acknowledgement record here.

Accepted file types: pdf, jpg, Max. file size: 10 MB.

Approving Director

Please select the approving Director for this project.

Director Name

Consent to Terms

Hidden

SAT Email Address