CUAnschutz Parking Agreement

Monthly Parker Agreement

Select One*

CU Anschutz Faculty CU Anschutz Staff Student Vendor Affiliate Visitors

Notice:

Applications are processed in the order received and you will be emailed after we complete your request. Normal time frame is 2-5 business days not including the weekend or holidays but can be several more during peak times. PARKING DOES NOT CANCEL UNTIL YOU SUBMIT THE ONLINE CANCEL REQUEST FORM. It is your responsibility and only yours to make sure parking charges are started correctly and that your parking is paid for each month. Please do not submit multiple applications. Thank you!!

Notice:

Applications are processed in the order received and you will be emailed after we complete your request. Normal time frame is 2-5 business days but can be several more during peak times so you should always provide one week or more notice not including weekends or holidays. Please do not submit multiple applications.

By submitting this application you agree to pay for the requested parking until you submit the cancellation request online form which must be done in advance. Parking charges DO NOT stop until you submit the cancel request. The PARKING PORTAL is only used to make one-time payments, add credit card for auto paying or to update your information including vehicles. The PARKING PORTAL IS NOT USED to sign up or cancel. Removing your credit card does not stop charges from continuing or cancel your parking. If YOU CHOOSE “YES” TO AUTO RENEW THEN YOU HAVE TO ADD YOUR CREDIT CARD TO THE PARKING PORTAL AND LINK IT TO YOUR PARKING PERMIT AFTER YOU ARE SIGNED UP. It is your responsibility and only yours to pay for parking. Thank you!!

Faculty/Staff Parking

Faculty/Staff Permit Options - Select One or More

Permit Parking - $73 Full Time - Part Time Parking $44 - Park 12 days or less Mon-Fri Part Time Permit Parking - $44 (Employed/Paid less than 20 hours a week – unlimited days) Carpool Parking - $44 ECOPass - $25 if choosing Eco Pass only. The EcoPass is only available when using the RTD MyRide app Nights/Weekends - $0 Reserved Parking - $99

Rock Lot West - $37

Rock Lot East - $37

Vendor Parking

Note: You must have a CU Anschutz badge for gated parking

Vendor Permit Options - Select One or More

Permit Parking - $73 Carpool Parking - $44 Reserved Parking - $99 Rock Lot East - $37 ECOPass - $25 if choosing Eco Pass only. The EcoPass is only available when using the RTD MyRide app

Visitors Parking

Note: You must have a CU Anschutz badge for gated parking

Visitor Type:*

Non-Affiliate Student Temporary Student Volunteer

Non-Affiliate Permit Option*

Permit Parking - $73/month

Student Permit Options - Select One or More*

Permit Parking - $41/month Rock Lot East - $15/month ECOPass - $25 if choosing Eco Pass only. The EcoPass is only available when using the RTD MyRide app

Temporary Student Volunteer*

EAST Rock lot (Only East – West is not available to students) - $15/month

Student Parking

Note: You must have a CU Anschutz badge for gated parking

Student Permit Options - Select One or More

Permit Parking - $41/month Carpool Parking - $22/month each Nights/Weekends - $0 Reserved Parking - $99/month

EAST Rock lot (Only East – West is not available to students) - $15/month

Affiliate Parking

Note: You must have a CU Anschutz badge for gated parking

Affiliate Permit Options - Select One or More

Permit Parking - $73/month Carpool Parking - $44/month Reserved Parking - $99/month Rock Lot East - $37/month ECOPass - $25 if choosing Eco Pass only. The EcoPass is only available when using the RTD MyRide app

Additional options

Nights/Weekends - $0 Eco Pass - $0

Carpool Partner Information

Carpool Partner Name #1*

First Name

Last Name

Do you have another carpool partner to add?

Yes No

Carpool Partner Name #2

First Name

Last Name

Do you have more carpool partners to add?

Yes No

Carpool Partner Name #3

First Name

Last Name

Carpool Partner Name #4

First Name

Last Name

Please indicate the month you want parking to start. We only prorate the Full time permit and Reserved by the half month with starting dates either the 1^st or 15^th of the month and ending dates either the 15^th or last day of month.

Employee Month Selection
	JAN	FEB	MAR	APR	MAY	JUN	JUL	AUG	SEP	OCT	NOV	DEC
Select Month	Employee Month Selection: Select Month (JAN)	Select Month (FEB)	Select Month (MAR)	Select Month (APR)	Select Month (MAY)	Select Month (JUN)	Select Month (JUL)	Select Month (AUG)	Select Month (SEP)	Select Month (OCT)	Select Month (NOV)	Select Month (DEC)

Do you want your parking to renew automatically at the end of each month?*

Yes No

*NOTE: If you select Yes for automatic renewals, please ONLY select the month that you would like to start parking below AND You will be required to Add your credit card to the parking portal for the system to auto pay each month

Student Select month you want to start parking

Students please indicate which month you want to start parking

Student months selection
	JAN	FEB	MAR	APR	MAY	JUN	JUL	AUG	SEP	OCT	NOV	DEC
Select Months	Student months selection: Select Months (JAN)	Select Months (FEB)	Select Months (MAR)	Select Months (APR)	Select Months (MAY)	Select Months (JUN)	Select Months (JUL)	Select Months (AUG)	Select Months (SEP)	Select Months (OCT)	Select Months (NOV)	Select Months (DEC)

NOTE: Please indicate if you ONLY need a partial month. We only prorate the Student $40 permit by the half month with starting dates either the 1st or 15th of the month and ending dates either the 15th or last day of month.

Visitors select month you want to start parking

Students please indicate which month you want to start parking

Student months selection
	JAN	FEB	MAR	APR	MAY	JUN	JUL	AUG	SEP	OCT	NOV	DEC
Select Months	Student months selection: Select Months (JAN)	Select Months (FEB)	Select Months (MAR)	Select Months (APR)	Select Months (MAY)	Select Months (JUN)	Select Months (JUL)	Select Months (AUG)	Select Months (SEP)	Select Months (OCT)	Select Months (NOV)	Select Months (DEC)

NOTE: Please indicate if you ONLY need a partial month. We only prorate the Visitory $72 permit by the half month with starting dates either the 1st or 15th of the month and ending dates either the 15th or last day of month.

Student Select multiple months no auto renew

Students please indicate which months you need parking only if you want a set period of time which you will have to pay for with a one-time payment.

Student months selection
	JAN	FEB	MAR	APR	MAY	JUN	JUL	AUG	SEP	OCT	NOV	DEC
Select Months	Student months selection: Select Months (JAN)	Select Months (FEB)	Select Months (MAR)	Select Months (APR)	Select Months (MAY)	Select Months (JUN)	Select Months (JUL)	Select Months (AUG)	Select Months (SEP)	Select Months (OCT)	Select Months (NOV)	Select Months (DEC)

Select the months you want to pay for parking

NOTE: Please indicate if you ONLY need a partial month. We only prorate the Student $40 permit by the half month with starting dates either the 1st or 15th of the month and ending dates either the 15th or last day of month.

Visitors select multiple months no auto renew

Students please indicate which months you need parking only if you want a set period of time which you will have to pay for with a one-time payment.

Student months selection
	JAN	FEB	MAR	APR	MAY	JUN	JUL	AUG	SEP	OCT	NOV	DEC
Select Months	Student months selection: Select Months (JAN)	Select Months (FEB)	Select Months (MAR)	Select Months (APR)	Select Months (MAY)	Select Months (JUN)	Select Months (JUL)	Select Months (AUG)	Select Months (SEP)	Select Months (OCT)	Select Months (NOV)	Select Months (DEC)

Select the months you want to pay for parking

NOTE: Please indicate if you ONLY need a partial month. We only prorate the $72 permit by the half month with starting dates either the 1st or 15th of the month and ending dates either the 15th or last day of month.

Student Select Carpool multiple months

Students please indicate which months you need parking only if you want a set period of time which you will have to pay for with a one-time payment.

Student months selection
	JAN	FEB	MAR	APR	MAY	JUN	JUL	AUG	SEP	OCT	NOV	DEC
Select Months	Student months selection: Select Months (JAN)	Select Months (FEB)	Select Months (MAR)	Select Months (APR)	Select Months (MAY)	Select Months (JUN)	Select Months (JUL)	Select Months (AUG)	Select Months (SEP)	Select Months (OCT)	Select Months (NOV)	Select Months (DEC)

Select the months you want to pay for parking

Faculty/Staff/Student Information

Name on Badge*

First Name

Last Name

EMPLOYEE PAYROLL/STUDENT ID# (not your badge number)*

CIDEX Number (no dash or space please)*

####NAMEMMDD - Last 4 of Social Security number / First 4 letters of your last name (if shorter than 4 letters fill in with the underscore character “_” / 2 digits for birthday month and 2 digits for birthday day)

Work or School Email*

Home Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Personal Phone*

Business Phone

Additional Notes:

Vendor/Visitor Information

First and Last Name*

First Name

Last Name

ID# (First letter of first name + Last Name)*

CIDEX Number (no dash or space please)*

First 4 letters of last name - MMDD of DOB - Last 4 of Social

Email*

Home Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Personal Phone*

Business Phone

Additional Notes:

Affiliate Information

First and Last Name*

First Name

Last Name

Employee ID# (4 digits for CU Med - 5 digits for UCH)*

CIDEX Number (no dash or space please)*

First 4 letters of last name - MMDD of DOB - Last 4 of Social

Email*

Home Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Personal Phone*

Business Phone

Additional Notes:

Payroll Deduction

Hours Per Week*

Full Time Part Time (less than 50%)

Payment Schedule*

Monthly Bi-Weekly

Payroll Deduction Option*

Pre-Tax Post-Tax

Start Deduction:*

I hereby authorize Parking and Transportation Services to deduct the following amount per month (this is subject to annual increases) from my paycheck on the last day of the month. I understand that this deduction will continue each month as long as the entry card and/or permit is in my possession. The entry card and/or permit must be returned to the Parking Office before my payroll deductions will stop.

Deduction Amount

Deduction Amount*

Please read and mark that you agree to the following:*

If I have a second badge other than the CU Anschutz badge, I will present only the CU Anschutz badge to the reader and leave the other badge(s) in the vehicle I understand that driving through an Open Gate that my badge will not work the next time I try to use it.**unless all gates are open which at that time the University will reset all badges** I will try to avoid going in or out an Open gate by choosing to use a different entrance or exit as each lot has two I will call the Parking Office if I drive through an Open gate so my badge can be reset

Vehicle Information (Must include License Plate Numbers)

License Plate Number (no dash or space please)*

State*

Make*

Model *

Year*

Color*

Do you have another vehicle to add?*

Yes No

Vehicle Information (Must include License Plate Numbers)

License Plate Number (no dash or space please)*

State*

Make*

Model *

Year*

Color*

Do you have another vehicle to add?*

Yes No

Vehicle Information (Must include License Plate Numbers)

License Plate Number (no dash or space please)*

State*

Make*

Model *

Year*

Color*

Terms and Conditions:

I hereby certify that this information is true and agree to the terms and conditions herein and the rules and procedures that follow.

Signature*

[clear]

Use your mouse or finger to draw your signature above

Date:

Parking Agreement

This agreement is made between the “Customer” listed above and The University of Colorado Anschutz Medical Campus and Standard Parking. As part of this agreement, the customer who parks with the University and Standard Parking agrees to all conditions of the agreement.

Eco Pass Instructions:

Follow the directions found HERE to create a new account on the app using the email address associated with your CU Anschutz parking account and choose your own password. You will receive an email link to verify your account set up.

IMPORTANT If you signed up with your ucdenver email address and have never changed it, then please use that email not the cuanschutz extension email that you may use now. If you do not have an University email address then your personal email that you signed up with will be used.

I Agree

Nights and Weekends:

For parking in University of Colorado Anschutz Medical Campus gates permit lots only. Hours of authorized parking are 6:00PM to 6:00AM Monday-Friday and all Saturday and Sunday. No exceptions are granted under this arrangement. If the customer has the need to park on campus outside of the established time frame the customer agrees to park in visitor pay parking lots and pay the posted daily rate for the time parked. The customer agrees that if they park in the permit parking lots beyond the hours outlined in the agreement they will be charged the daily rate for the additional number of hours they are parked.

I Agree

The Customer agrees to pay for their parking access and the amount of monthly parking. Payment is due on the first of the month. If payment is not received their parking access may be deactivated or unauthorized and the parking Customer(s) will have to pay the normal daily rate and/or parking citation amount until the parking balance is paid up to date. Parking will not reimburse daily parking or citations that may occur when monthly parking balance is in arrears and parking has been deactivated due to non payment.

I Agree

Only authorized parkers will be allowed to park. Cars parked in handicapped stalls must display a valid handicapped permit. The entry card or permit is issued exclusively for the Customer’s use. Unauthorized use of an entry card or permit may result in revocation of parking privileges. If a vehicle is left unattended for more than two days the Customer must notify the Parking Office. Vehicles without prior notice may be ticketed or removed at the owner’s expense. The Customer agrees to provide the University/Standard Parking with any changes for their account on a timely basis. All vehicle(s) information such as license plate, vehicle make, model, etc. must be kept current.

I Agree

Employees must pay for parking via pay roll deduction. This deduction will continue until the parking office has been contacted to stop or cancel parking.

I Agree

This agreement may be canceled with a written notice and the return of the access card and/or hang tag. The notice may be faxed, mailed or hand delivered to our office. It is the Customer’s responsibility to ensure that the University/SP+ is in receipt of the cancellation. The Customer (and its employees) acknowledge and agree that the University and SP+ shall not be responsible or liable for the loss of or damage to vehicles or articles of personal property left in vehicles parked in the parking facility. Each vehicle is parked at the parker’s risk. There will be an administrative fee charged for all returned checks. In the event the Customer is in default, the Customer agrees to pay all costs of collections and attorney fees with interest. The signature on this agreement acknowledges that the Customer (and its employees) have read, understand, and agree to all of the above terms and conditions. There are no outside conditions, verbal agreements, or understandings.

I Agree

I have read all of the above and have received a copy of the “Most Commonly Asked Questions” form:

Student FAQ

Faculty/Staff FAQ

I Agree