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EmployeeLink This system is working normally. If you experience any
      problems, please report them to the ACT Help Desk at (858)534-1853
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      problems, please report them to the ACT Help Desk at (858)534-1853
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Department Index
Risk Management Insurance Forms  
 
Summary: Use these forms to request insurance, protect your department from liability, or communicate information to Risk Management.


Select a category:

Automobiles
Change Form: UCSD Vehicle Insurance (PDF) (Word)
UCSD Auto Accident Report (PDF)

Aviation
Pilot History Form (PDF)

Boiler and pressure vessels
Air Pressure Tank and/ or Boiler Change Form (PDF) (Word)

Business travel: out of state & foreign
UC Business Travel Form
Business Travel Accident Insurance information
for out of state and foreign travel only
(PDF) (Word)


Fine arts
Permanent Fine Arts Policy Form (PDF) (Word)
Quarterly Reports: Domestic Exhibits
  (print using landscape setting)

(PDF)
Marine
Marine Insurance Change Form (PDF) (Word)

Special events
Event Application – Commercial General Liability, long form (Note: This form is 7 pages long) (PDF)
Event Holder Questionnaire, short form (PDF)

Transit
Domestic Transit Risk Program Prior Approval Form
 (for domestic shipments over $100,000)
(PDF) (Word)
Foreign Shipment Insurance Request (PDF) (Word)

Waiver of liability, assumption of risk, and indemnity agreements
Elective/ Voluntary Activity (Vol Waiver 7/01) (PDF)
Required (Req Waiver 7/01) (PDF)
Facilities Use (FacUse 2/01) (PDF)
Athletics (FacUse-Athletics 7/01) (PDF)
Group (Group Waiver 7/01) – Consolidates signatures for very large groups; not recommended for high-risk activities (PDF)

Need an expert? Contact Risk Management, (858) 534-2454.

Notice: When a loss occurs, notify EH&S Risk Management, (858) 534-3820, immediately to promptly initiate the insurance investigation and claim process. Use pager number (858) 583-3302 for emergencies only. Take a picture if a camera is available.

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Last reviewed/updated on Nov. 21, 2007 (see more info)
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