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Important
Note:
Forms are to be used as a guide only to assist you. No liability is assumed for errors in substance or form. It is your responsibility to revise the forms to meet current law
requirements and your particular situation. No liability is assumed for improper use of these forms.
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MEMORANDUM
OF EMPLOYEE AUTOMOBILE EXPENSE ALLOWANCE
WHEREAS, The
employee whose signature appears below agrees to furnish his own
automobile to
perform his duties hereunder and shall keep it maintained and repaired in good
driving
condition; and
WHEREAS, for the
employee's benefit, the employee shall maintain insurance on the
automobile in at
least the following amounts: Bodily injury liability, _________ Dollars
($_______)
for each person
injured, ___________ Dollars ($_______) for each occurrence; property damage
liability
____________ Dollars ($_______) for each accident; _____________ Dollars
($_______)
deductible
comprehensive coverage, ____________ Dollars ($_______); ___________ Dollars
($_______)
deductible collision coverage at fair market value; and
WHEREAS, a
certification of the employee's insurance showing those coverages will be
filed by the
employee with the company; and
WHEREAS, all of
the requirements of this section shall be complied with at the employee's
cost.
NOW THEREFORE,
In consideration of the above, the company shall pay the employee
_________
Dollars ($_______) per week for the use of his automobile during the period from
____________,
19____, to ____________, 19____. Those payments shall be charged to the
employee's
account as an automobile allowance. The payments shall be made weekly, but
neither
the payments nor
this agreement shall make the company the owner, bailee or lessee of
said automobile,
nor shall the company be responsible for any damage to the automobile.
_____________________________
Employer
Employee
_____________________________
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