Rensselaer Polytechnic Institute
Office of Property Administration - Modular Office Building 01

This form must be attached to a completed Equipment Change Request/Notification Form and forwarded to Property Administration if the item was purchased as a Capital Equipment Item. If not, complete the form and keep a copy in your office files for auditing purposes.

 Purchase Price $  +8% Sales Tax **$   = Total Amount Owed $

does hereby grant, sell and convey all right, title and interests in and to the following:

List in detail the item that is being sold. Please include the Tag number.

unto ___________________________________, hereafter referred to as the "Buyer".
Rensselaer warrants that it is the lawful owner of the property listed above and said property is sold free and clear of any claim of others. Upon payment to Rensselaer of the sum listed above, title and ownership to the property shall pass to the Buyer, who shall assume total responsibility for safe removal of the property from Rensselaer.
The property hereby transferred is sold as is, and Rensselaer makes no warranty of any kind, express or implied, with respect to the property, including but not limited to, warranties of merchantability for a particular purpose. Rensselaer shall not be liable for any damages including but not limited to indirect, special or consequential damages arising out of or in connections with the performance, use of or inability to use the property hereby transferred.
The buyer agrees to indemnify, defend and hold Rensselaer harmless from any claims, causes of action and legal proceedings, and costs and expenses, including reasonable attorney fees, incurred by or resulting from injury to person(s) or property caused by the purchased property, use or operation of the property, and removal from Rensselaer.

For Rensselaer Polytechnic Institute:
  Title   Department
  Signature   Date

For Buyer:
  Organization/Company Name
  Signature   Date
  ** Tax Exempt Identification Number (if applicable)