Team:__________________

The team consisting of _______________________ name 1 _______________________ name 2 _______________________ name 3

______________________ student account number ______________________ student account number ______________________ student account number

_____________ date _____________ date _____________ date

willingly accept as a loan the equipment listed below. This equipment is the property of the Robotics Institute at Carnegie Mellon University and must be returned in a like-new usable condition on the last day of classes in the Spring 2007 semester or sooner, if an entire group drops the class. The group members must check all items within 48 hours of receiving them for damage. After this point, it is the group members' responsibility to care for this equipment and replace all damaged items. We have provided a parts list with their cost.

Failure to return these parts constitutes a violation of academic integrity. Groups who do not return the equipment will have their grade withheld until the equipment is returned and will be subject to the University Disciplinary Committee.

On the last day of the class in the Spring 2007 semester, however, the members can write a check payable to Carnegie Mellon for the replacement cost of the unreturned items.

Certification of completeness: _______________________ name 1 _______________________ name 2 _______________________ name 3

______________________ student account number ______________________ student account number ______________________ student account number

_____________ date _____________ date _____________ date

verify that the kit loaned to us is complete.