State Vehicle Request Form | Customer Survey: Motor Vehicle Services
Use of State Vehicles
KUSM-W Vehicle Management Policy provides vehicles for transportation for a minimal fee. This service is available to:
(1) University departments, other University related organizations and classes of individuals approved by the Kansas Board of Regents. Only authorized personnel in these groups engaged in official University business may utilize this service. Under NO CIRCUMSTANCES can a state vehicle be driven or operated by family members or travel in a state vehicle. Vehicles may not be driven to an employee's residence unless their residence is en route to business destination, and must obtain prior approval by the Facilities Director.
(2) Students may drive a state vehicle if the student is a state employee, assigned to perform official state business for which the renting department has hired the student.
Reservations for a state vehicle are required at least 24 hours in advance before the anticipated travel date with the Facilities Management office. If a state vehicle is unavailable, departments may consider using the state contract for vehicle rentals. A request for Use of State Vehicle must be submitted to Facilities Management when reservations are made. Facilities Management will send an email to the requestor advising of the confirmed reservation date and assigned vehicle. (The Facilities Department will manage vehicle reservations and may alter, change or reassign vehicles based on demand, usage, and priorities.) If seats need to be removed or installed in the vehicle, we require at least 24-hour notification.
The following items will be distributed at check-out:
- Credit Cards: WEX Fleet gas cards
- KTAG for use of Kansas Turnpike as needed (KTAG's are now affixed under the rear view mirror in the vehicle)
- Gate Remote for KUSMW parking lot #2 located at northeast corner of 10th & Minneapolis. Use gate remote to open the gates from 6 p.m. to 7 a.m., Monday - Friday and on weekends
- Vehicle Use Form
- Beginning and ending mileage of vehicle odometer
- Record of gas receipts and usage
- Entrance and exit location for starting trip and return trip for Kansas Turnpike
- Comments section should include any mechanical malfunctions that occur during the trip
- Proximity card if traveling to KUMC, which allows KUSM-W state vehicles to park on campus in the Olathe II Visitors Parking Garage. Vehicles can also be parked in the red, yellow, or blue permit-required parking lots at KUMC.
Upon return of your trip, please remember to:
- Pick Up or Return the state vehicle at the fenced parking lot on the corner of 10th & Minneapolis unless previous arrangements were made with the Facilities office. The gate to the fenced parking lot is open between 7 a.m. - 6 p.m., Monday-Friday
- If you are returning after 6 p.m., please return the vehicle to the gated lot.
- Contact Security (648-8329) if you need assistance between 6 a.m. - 10 p.m., Monday-Friday.
- The vehicle folio, credit card, keys, and gate remote must be returned to Facilities Management. If you are returning after 4:30 p.m., the keys may be given to the attending Security Officer or returned to the Facilities office at 8 a.m., the next business day.
- Please return gas receipts and miscellaneous vehicle receipts when the keys are returned.
- If any seats were removed by the driver before the trip, please replace them when trip is over.
- Record the state vehicle tag number (license plate #) on your records if you will be submitting a travel voucher for personal travel reimbursement. (Many times the forms request this information).
- 2012 Chevy Equinox - State of Kansas Vehicle Tag #15103
- 2006 Dodge Grand Caravan - State of Kansas Vehicle Tag #11658
- 2007 Ford Freestar - State of Kansas Vehicle Tag #12215
- 2007 Ford Focus - State of Kansas Vehicle Tag (2 vehicles available) #15060 or #15061
- 1997 Dodge Ram Van (15 Passenger) - State of Kansas Vehicle Tag #04932
Vehicle Mileage Fees is equal to current state reimbursement rate for mileage. No mileage fee for travel in Wichita metro area (vicinity mileage)
Use of State Vehicle Request Form Procedures
- Department or state employee at KUSM-W will need to submit a State Vehicle Request Form located on the Facilities Web site.
- State employees may proxy the Vehicle calendars in Outlook to determine if a specific vehicle is available.
- Vehicle calendar addresses include:
- Chevy Equinox (2012)
- Dodge Grand Caravan (2006)
- Ford Freestar Minivan (2007)
- Ford Focus (2007) (2 vehicles available)
- Dodge Van Vehicle (1997 15-passenger)
- Upon receipt of a state vehicle request form, Facilities Management will verify the vehicle availability for the date requested and send an email to the requestor confirming the date and assigned vehicle.
- During check-out the driver will be given the vehicle use form, credit cards, keys, gate remote and KTAG if applicable. The vehicle portfolio will include:
- Monthly vehicle usage log that requires the ending mileage to be recorded upon return of trip.
- Accident & Emergency Repair information
- Use of state vehicle information
- Automobile loss notice
- All state vehicles are self-insured and carry liability insurance
- Insurance Carrier:
Berkshire Hathaway Homestate Companies
555 Poyntz Avenue, Suite 205; PO Box 1989
Manhattan, KS 66505-1989
Phone Number: 785-537-1600
Claims Reporting: 800-356-5750
Policy #: 02APM007372-01; State Contract #40564
- Upon conclusion of trip, the vehicle use form will be returned to Facilities Management with all required data recorded. All gasoline receipts, miscellaneous receipts, keys and gate remote are to be turned in at this time.
- All vehicles should be returned to the fenced parking lot #2 at the northeast corner of 10th & Minneapolis. If you are returning the vehicle after 6 p.m., the keys may be given to the attending security officer. The gates to the fenced parking lot are open 7 a.m. - 6 p.m.
If an accident occurs involving a privately owned, state-owned or leased motor vehicle being used for official state business, please refer to the detailed information for insurance provided in the vehicle folio:
- Report the accident to the proper law enforcement authorities:
- Kansas Highway Patrol (785) 296-6800, M-F, 8am-5pm. If you are on a Kansas state highway you can dial *47 on your cell phone.
- Kansas Turnpike Authority and/or Kansas Turnpike State Trooper at 316-682-4537 or *582 on cell phone
- Wichita Police Department or Sedgwick County Sheriff - call 911
- The accident should be immediately reported by the vehicle operator or some other reliable person to the highway patrol or other law enforcement agency.
- If the accident occurs on the Kansas Turnpike contact the turnpike authorities at (785) 296-6800 or *582on cell phone.
- Statements should not be made to anyone except law enforcement officers, representatives of the state's insurance company, or motor pool or agency officials.
- Complete the insurance claim form provided in the vehicle folio: Acord Auto Loss Notice Form
- Information should be secured about the other party so a complete report can be made on the report form provided.
- A copy of the policy report or case number must be submitted to Facilities Management.
- What to do if you're involved in an accident using a Personal vehicle on State business:
- Contact the local police or sheriff's department to report the accident.
- If another party is involved, exchange information. Be sure to obtain their name, address, phone number, and insurance company's name, phone number, and policy number. You should not provide the other party with your personal insurance information. The Board of Regents Auto Liability Insurance Card is provided in the vehicle folio for reference.
- Immediately contact the State's liability insurance claims office, 800-356-5750, Berkshire Hathaway Homestate Companies. Identify yourself as a State of Kansas employee to ensure proper claim handling.
- Fill out the Accord Automobile Loss Notice form, and provide to Facilities Management within 24 hours of the accident or next business day.
- Follow any agency-specific procedures. Damage to a personal vehicle is the responsibility of the state employee, including any deductible.
- Injury accidents, if there is an accident in which there are serious injuries or death:
- Call the claim department of the state's insurance company at the # provided in the vehicle folio, and/or Facilities at 316-293-2625.
- The employee's immediate supervisor shall be notified at once by the employee involved in the accident. If the employee is unable to notify the employee's supervisor, then the first employee having knowledge of the accident should make the notification.
- 24-Hour Notification to Facilities Management
- A complete automobile loss notice report of all accidents shall be made to Facilities Management within twenty four hours of accident.
- It shall be the responsibility of the employee involved in the accident to protect state property from theft or further damage. If the employee is not able to do so, then the employee's immediate supervisor or the first employee having knowledge of the accident shall do so.
- The location of any damaged vehicle shall be reported to Facilities Management as soon as such information is available.
- Damaged vehicles shall be towed to state property to avoid storage charges.
Emergency Repairs or Roadside Assistance
Please call KUSM-W Facilities Management, 316-293-2625, 7 a.m. - 4:30 p.m. M-F, or Bob Wiese at 316-648-2456.
Emergency repairs under $500.00 may be charged to the WEX Fleet Gas Card, if the service station accepts the WEX Card, and has service facilities and will do the repair. Repairs done by other vendors will require a purchase order number. If you need emergency repairs while operating a state vehicle and the cost is estimated to be over $500.00, call KUSM-W for approval before authorizing repairs. Facilities Management with secure a purchase order number and/or credit card #, along with permission to proceed with the repairs. Vehicle damage, excluding ordinary repairs and maintenance, shall be billed to the responsible department.
Reportable road conditions are available for inclement weather and construction areas by calling the below phone numbers:
· Kansas Highways - Dial 511
· Oklahoma: 405-425-2385
· Missouri: 800-222-6400
· Nebraska: Dial 511 and select state and enter highway #
Jan 20, 2017