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COVID-19 Acknowledgement and Release Form For Vendors

I acknowledge and agree to the following terms as a condition of being allowed on the WPI campus:

Term 1

The novel coronavirus, COVID-19, is a highly infectious, life-threatening disease declared by the World Health Organization to be a global pandemic. There is no current vaccine for COVID-19. COVID-19’s highly contagious nature means that contact with others, or contact with surfaces that have been exposed to the virus, may lead to infection. Because of its highly contagious and sometimes “hidden” nature, it is currently very difficult to control the spread of COVID19 or to determine whether, where, or how a specific individual may have been exposed to the disease. I understand and acknowledge that given the unknown nature of COVID-19, it is not possible to list each and every individual risk of contracting COVID-19.

Term 2

Within the past fourteen (14) days, I have not tested positive for COVID-19, nor am I aware of being in close contact with someone, including any member of my household, who has tested positive for COVID-19, is being tested for COVID-19, or has COVID-19-like symptoms.

Term 3

I agree that I will not come to campus if I have a fever or other COVID-19-like symptoms; if I am advised to self-isolate or get tested for COVID-19; if I test positive for COVID-19; or if I have been in close contact with someone, including any member of my household, who I know has tested positive for COVID-19, is being tested for COVID-19, or has COVID-19-like symptoms. For purposes of contact tracing, I will immediately report any positive COVID-19 test, for myself or a close contact, to WPI on this form.

Term 4

I understand and acknowledge WPI’s Coronavirus (COVID-19) Resources and Updates website related to mitigating the spread of COVID-19, including the requirement of performing a daily self-check for symptoms; staying home if I am sick; wearing a cloth face covering; maintaining physical distance and staying at least six feet from others; washing my hands frequently with soap and water for at least 20 seconds or using alcohol-based hand sanitizers with at least 60% alcohol; avoiding touching my face, eyes, nose, and mouth; covering my coughs and sneezes; throwing out used tissues and washing my hands; and avoiding shaking hands, hugging, or touching when greeting another person on campus.

Term 5

I agree to comply with instructions concerning access to buildings and spaces on campus, including occupancy limits and building and office-specific signage, including elevator limits, one-way hallways and stairwells, restroom limits, and designated entrances and exits.

Term 6

I understand and agree that WPI has the discretion to determine whether I am permitted to be on campus, or in a particular building, and at any time may require me to leave and not return to campus if it is determined that I have not complied with WPI or public health policies or guidelines, or if my presence on campus poses a health risk to others.


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