PASSDOWN REQUEST FORM

*A valid Certificate of Insurance (COI) is required prior to Vendor access. Please contact summitadmin@urbanrengroup.com for information about Certificate of Insurance requirements.*

Company: *

Suite Number: *

Vendor/Contractor Company Name: *

Name of Individual Needing Access: *

Contact E-mail: *

Contact Phone: *

Access Start Date: * +

Access End Date: * +

Access Start Time: *

Access End Time: *

Purpose for Requesting Access (Please include ALL details, including scope of work/delivery details): *

My Vendor will require loading dock access: *

Yes

No

What type of vehicle will need access (Note, only ONE vehicle will be permitted): *

Large Box Truck (20' to 28')

Small/Medium Box Truck (10' to 19')

Cargo Van

Passenger Vehicle/Pick-Up Truck

Other (Please include dimensions) Other (Please include dimensions)

Additional Access Requested (optional):

Vendor Access Badge

Freight Elevator

I have read and understand the Loading Dock & Deliveries information page on The Summit's website HERE. *

I AGREE

I will share all relevant information to our Vendor from the Loading Dock & Deliveries information page as it pertains to this visit. *

I AGREE

PLEASE ALLOW 48 HOURS TO REVIEW AND APPROVE YOUR REQUEST.

Requestor Name: *

Authorized Signature: *

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