Risk Management ForumThursday, October 14, 2010

Contracts, Procurement, & Risk Management

Phone : 756-2232 or 756-6755

riskmanagement@calpoly.edu

• David Carroll, Risk Manager, 6666• Melissa Swanson, Risk Analyst, 6755

Today’s Topics

•Waiver of Liability form; fresh from the CSU Chancellor’s Office

• Approved Drivers: who, what, where, when, how & why

New Approved Waiver of Liability CSU Executive Order 1051

The objective of risk management is to reduce the adverse effects of losses experienced by the university. One method of controlling risk is the use of third party waivers.

What’s a waiver?

• An agreement that informs the participant that there are risks associated with an activity. Accidents do happen.

• By signing the release they are accepting personal responsibility for these risks and any needed medical care.

• By signing they are promising NOT to sue the university.

Who needs to sign waivers?

• Students, 18 or older, who choose to participate in the activity

• For minors, <18 years old, a parent or legal guardian must sign

• The general public, if participating in an open event. Parents must sign for minors.

When do we use waivers? When your risk analysis of the activity

determines that it is beyond routine risk. Could include the following:

• Field trips • Club or program activities• Out of the classroom and off campus travel for students• Class projects or lab work• High risk or physical activities: organized hikes, 5K

events, walks, bike rides, axe throwing, other recreation events: beyond routine risk

• Conferences and workshops

When do we use other waivers?

Certain activities require additional considerations for the agreement:

• Field trips longer than three days: participation agreement

• International Travel • Sports Club or high risk program activities

All international travel involving students must go through International Education Programs (IEP) http://www.calpoly.edu/~iep/index.html

What’s NEW about the waiver?

• Combines the previous two page document into one page

• Includes direct references to travel to and from the activity

• More direct language: “I promise not to sue …”

AFDWebsite

RELEASE OF LIABILITY, PROMISE NOT TO SUE, ASSUMPTION OF RISK AND AGREEMENT TO PAY CLAIMS

• Activity: Annual race to the “P” while juggling chainsaws

• Activity Date(s) and Time(s): Saturday, October 16, 2010 1:00 PM

• Activity Location(s): University Plaza to the “P” and back

• Risks specific to this Activity: falls, sprains and strains, chainsaw cuts, skinned knees, blisters, dehydration

Driving on University Business

Faculty, Staff, Student or “Other”

Laurie LipsonEnvironmental Health & Safety

756-6665

AFDWebsite

CAL POLY ENVIRONMENTAL HEALTH & SAFETY REQUEST TO OPERATE VEHICLES ON UNIVERSITY (STATE) BUSINESS

REQUESTOR INFORMATION (Print legibly or type) UNIVERSITY STATUS

PHOTOCOPY OF DRIVERS LICENSE IS REQUIRED TO ACCOMPANY THIS FORM PLEASE CHECK APPROPRIATE BOX(s) :

Requestor Name: University Faculty or Staff

LAST FIRST M University Van Pool Driver

Department: Campus email: @calpoly.edu University Student Asst. (*In dept. driving for)

CA Driver’s License No.: Expiration Date: Identified Volunteer – HR Form V-1 must be completed and attached

Requestor Birth Date:

Requestor Campus Phone #: 6- Other Phone #:

Corporation employee ASI employee Other

REQUESTOR CERTIFICATION

I certify that:

1. I am in possession of a valid California or other State driver’s license (see attached copy). I have not been issued more than three moving violations or have been responsible for more than three accidents (or any combination of more than three thereof) during the past twelve-month period. I authorize Environmental Health & Safety to request a copy of my driving record from the CA DMV to confirm.

2. Operation of any vehicle on University (state) business will be in compliance with applicable laws, policies, regulations and safety requirements.

CSU Use of University and Private Vehicles Policy Guidelines are available on the web at CSURMA Policy Guideline California Department of Motor Vehicles Handbooks are available at DMV Handbooks

3. If authorized to operate a vehicle on University (state) business at least once per month regularly through out the fiscal year, I will complete the on-line, University Defensive Driver Training Program, upon notification of my ID and password supplied by Risk Management, (renewable every four years).

4. Vehicles owned, leased or rented by the University will only be used on University business.

5. Separate authorization will be obtained for use of personal vehicles on University business. (See Form 261)

6. Vehicles rented for use on University (state) business will be rented through State or University contracts worldwide, if available. (See State Travel)

7. Any accident in a vehicle being driven on University business will be reported as soon as possible or within 24 hours to Risk Management, (805)756-6755, nights, weekends, and holidays report to University Police, (805) 756-2281.

8. Drivers of vehicles being driven on University Business will file a completed report of Vehicle accident STD 270 with Risk Management within 48 hours. Detailed information and forms can be found at http://www.afd.calpoly.edu/cprm/vehicleaccident.asp. Requestor’s Signature: Date:

SUPERVISOR’S AUTHORIZATION The above named University employee is required to operate vehicles on University (state) business (please check one box):

more than once a month no more than once per month I have verified that this applicant possesses a valid California or other State driver’s license of appropriate class and I have verified the applicants UNIVERSITY STATUS as checked above.

Authorized By: Date: Signature

Print/Type Name: Dept. Bldg. & Rm #:

Print/Type Title: Dept. Phone: 6-

Upon completion of this form, please submit to Environmental Health & Safety, Bldg. 80. EH&S will notify the supervisor if the DMV record does not meet the established criteria for an approved University driver. Information Security Notice: This document contains Level 1 confidential employee information. Completed forms should NOT be retained in the originating department and must be handled pursuant the Cal Poly Information Classification and Handling Standard.

University Faculty or Staff

Send in the Completed Form With a Copy of Drivers License

Renew every FOUR Years

X

University Student Assistant

Is PAID for his/her work

Send in the Completed FormWith a Copy of Driver’s License

Renew Every Year

X

Corporation EmployeeEmployee is NOT employed by the State of California

Send in the Completed-“Request to Operate Vehicle on University Business” form with

Copy of Driver’s License to - Environmental Health & SafetyBuilding 80

Identified Volunteer – HR FormHR, Bldg. 1, Room 110

Renew every year

X

X

X

X

ASI EmployeeEmployee is NOT employed by The State of California

Send in the Completed-“Request to Operate Vehicles On University Business”

Form with Copy of Driver’s License toEnvironmental Health & Safety

Building 80

Identified Volunteer – HR FormHR Building 1, Room 110

Renew Every Year

X

X

OtherVolunteer and/or Student who is not employed by

The State of California

Definition of Student Volunteer is -A Non Paid Student volunteering his/her time.In addition a volunteer is – Alumni or Visitor

Send in the Completed -“Request to Operate Vehicles on University Business” Form along with Copy of Driver’s License - Environmental Health & Safety, Building 80

Identified Volunteer – HR FormHR Form is sent to:

HR, Building 1, Room 110

Renew every year

Defensive Driver Training Program

Only if you will be driving your OWN vehicle on State Business:This stays in your department files and is signed annually

STD. 261 (REV 3-95)

What constitutes driving on “University Business”?

• An activity that requires a Travel Form 1Ahttp://www.afd.calpoly.edu/FiscalServices/Forms/TRVL-1aform.xls

- If there are several people traveling in the car with the driver, attach a list of the people who are traveling in your car to the 1A

• An activity within the course and scope of your job

• An activity in which a person is designated as a University Volunteer (V1) for the express purpose of driving (through Human Resources)

Cal Poly State University Form 1A

Cal Poly State University Form 1A

To be completed by NON-STATE employees(i.e. Corporation or ASI staff; university volunteers)

Contact Information

• David Carroll, Risk ManagerPhone: 756-6666

• Melissa Swanson, Risk AnalystPhone: 756-6755

Our website:http://www.afd.calpoly.edu/cprm/riskmanage.asp?pid=5Email: riskmanagement@calpoly.edu

Main Phone: 756-6755 or 756-2232

Questions?