Impaired Vision Goggles Checkout Form
1. The goggles must be returned to the Kansas Traffic Safety Resource Office.
2. Return the goggles by certified parcel service, i.e., Federal Express, UPS, etc. Insure the contents for the replacement value of $900.00
3. The individual/organization named on this loan agreement is responsible for damage to and/or loss of the contents. While the contents are in your possession, it is recommended that they are insured for their replacement value of $900.