Access Card Request Building/Parking | Campus at Playa Vista

12035 Waterfront Drive | Suite 125 | Los Angeles, CA 90094 | 310-862-6467

Complete all required sections. When you click the submit button, this form will be directed to the Property Management Team. Requests received by 10 a.m. will be completed by 4 p.m. All new and lost replacement cards are $25.00 each.

Address:(Required)

12015 Waterfront Drive

12025 Waterfront Drive

12035 Waterfront Drive

12045 Waterfront Drive

Name:(Required)

First Last

Email:(Required)

Date:(Required)

Company:(Required)

Suite Number:(Required)

REASON FOR REQUEST

Select a Choice:

If you selected "Reassign", please note your badge number below:

Name (New cardholder or reassignment):

First Last

New Card Activation Date:

Card Deactivation Date:

Areas of Access:

Building

Parking (If "reserved"parking is required please contact the Parking Office at, 310-862-6467)

Building and Parking

Please enter the floors you need access to:

Hours of Access:

All Hours

Other

If other, please describe:

Vehicle Information (For Parking Access Requested)

Make:

Model:

Color:

License Plate Number:

Authorizations

Authorized Tenant's Signature (Office Manager):(Required)

First Last

Date:

Property Management Signature:

First Last

Date:

Cardholder's Signature (Employee):

First Last

Date:

Notes:

Tenant acknowledges that this Access Card(s) is to only be issued to and used by an authorized employee of the Tenant. Tenant assumes full responsibility for the control, custody and issuance of the Access card(s). Tenant shall indemnify, defend and hold Landlord, it's employees, contractors, agents and affiliates harmless from and against any and all claims, damages, unauthorized uses and causes of actions arising as a result of, or in connection with, any use of the Access Card(s) and from any and all costs, attroney's fees, expenses and liabilities incurred in the defense of any claim or any action or proceedings brought as a result of, or in connection with, such use.

Management use only

Tenant Billing Completed (if applicable) Date:

Security Use Only

Card Activation/Deactivation Date:

Card Number (New Cards Only)

Parking Office Use Only

Card Activation/Deactivation Date:

Billed for deposit date (Parking Access Only):

Input vehicle info. log date: