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Permanent Exhibition
Incoming (Long-term)
Purpose: Permanent Exhibition Display
Exhibition Section: 'I I f — &e -s
LAHM Exhibition Obje-c-t ID: -_Il%
Date of Receipt-. H - S7 - -2, -Z..
Return by Date (if available): rqA_
Digital File(s) Type (ex. jpeg, png-, '17117, mp3, rnp4, etc.):
File Size or Image Resolution (ex. M13, DPI, etc.): T.,
Credit Line or Label Preference (if available): Las
Loan #:
Agreement
This is to acknovAedge receipt of the items listed below by the Los Altos History Museum (LAHM) from:
Lending Name/Institu ion: LOS
Representative Name: 6 6fi;i
Street Address: 2
city: Lh-s lk( Z&(-���, j qu od �'
Phone: State: AT Zip code: I lid
- VT- ;LS13— Email: etdCV4n (a)SGLI as " �S- i�G . Ci llV
Brief Description of the Loaned Object(s) and Permission Notes/requirements:
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1 It is understood that the object(s) and/or digital file(s) in this loan will remain in the condition received and will not
be repaired, restored, cleaned, or altered in any way without the permission of the lender. The condition is understood
to be as stated on the form.
For objects displayed on museum grounds (outside): The lender understands that the ground and facilities of Los Altos
History Museum are open to the public for its use and enjoyment, and therefore is responsible for properly installing
and securing loaned materials in that setting. The Museum cannot ensure the safety of any property left unattended
and/or unsecured on its grounds and cannot be held liable for any injury to or loss of property due to theft, vandalism,
accident, fire, or through any other act or circumstance prior to, during or after the display period.
LAHM Permanent Exhibition Incoming Loan Form — Updated on 08.17,2021
Permanent Exhibition I Loan #:
2. All damages to object(s) or digital file(s) at any point in this loan from the in date until returned will be reported to
the lender immediately.
I The Los Altos History Museum agrees to use the object(s) or digital file(s) for the purposes stated on the form and
will not lend the object(s) to a third party without the written agreement of the lender.
4. Any object(s), photograph(s), digital image(s)/file(s) or stated loan exhibited shall be labeled and credited as specified
by the lender.
5. The object(s) or digital file(s) may be photographed or reproduced, respectively, by the Museum for use in collections
management procedures, exhibit program and marketing materials in print and online. All publication of photographs of
objects in this loan shall be labeled and credited as specified by the lender. The Los Altos History Museum cannot
restrict visitor cell phone and camera usage.
6. The lender is responsible for packing, transportationinsurance, and all other factors of transporting the loan, unless
otherwise stated. The Los Altos History Museum i , s responsible for contacting the lender at the end of the loan period in
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order to initiate the return of the loan. If the lender choses to use a courier, the Museum is not responsible for the
courier's actions.
7. The Los Altos History Museum may require proof of insurance, may wish to have its name on the policy, and may
wish to receive a copy of the insurance policy.
8. The Los Altos History Museum agrees to exercise the same care and safekeeping with respect to the loaned object(s)
and digital file(s) as it does with objects in its own collection.
9. If the ownership of the object(s) should change during the loan period, the new owner, or third party, will need to
provide the Los Altos History Museum proof of legal authority to receive the loan.
The Los Altos History Museum hereby acknowledges receipt of the stated object(s)/digital file(s) listed on this form or
any attached page(s) if applicable. The undersigned assumes full responsibility for the objects subject to the conditions
printed above until their return.
I have read and' ac the conditions of the loan.
Loan received by Museum (LAHN1}:
(Lender) Z� /S Z4
(Date)
(LAHM representative)
—(Date)
Loan returned:
(LAHM representative) (Date)
(Lender) (Date)
Courier Information - if applicable:
Name:
Signature:
Phone:
Email:
LAHM Permanent Exhibition Incoming Loan Form --- Updated on 08.17,2021