Converse Consultants - City of Moreno Valley

Converse Consultants
Geotechnical Engineering, Environmental & Groundwater Science, Inspection & Testing Services
Application for Authorization to Use
TO: Converse Consultants
10391 Corporate Drive
Redlands, California 92374
Project Title & Date:
Project Address:
FROM: (Please identify name & address of person/entity applying for permission to use the
referenced report.)
Applicant hereby applies for permission to use
the referenced report in order to:
Applicant wishes or needs to use the referenced report because:
Applicant also understands and agrees that the referenced document is a copyrighted
document and shall remain the sole property of Converse Consultants. Unauthorized use or
copying of the report is strictly prohibited without the express written permission of Converse
Consultants. Applicant understands and agrees that Converse Consultants may withhold such
permission at its sole discretion, or grant such permission upon agreement to Terms and
Conditions, such as the payment of a re-use fee, amongst others.
Applicant Signature:
Applicant Name (print):
Title:
Date:
CONVERSE Project No. 12-16-130-01
Copyright 2011 CONVERSE CONSULTANTS