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Complete and fax Requests for Certificates of Insurance, Hold Harmless Agreements, and Facility Use Agreements to the Risk Services Office in Oakland at (510) 987-0965.
For questions regarding the processing and/or submittal of a form or waiver, contact Linda Harris at:
(510) 987-0085
Attachment A: Preferred Hold Harmless and Indemnification Clause
If a facility use agreement contains a clause that compromises The Regents' assets by leaving open the potential for lawsuits from any and all parties, the County Director or Regional Director need to review the language and negotiate changes to the contract language (helpful hints for Attachment A).
Attachment B: Alternate Hold Harmless and Indemnification Clause
If a facility use agreement contains a clause that compromises The Regents' assets by leaving open the potential for lawsuits from any and all parties, the County Director or Regional Director need to review the language and negotiate changes to the contract language (helpful hints for Attachment B).
Attachment C: Request for Certificate of Insurance
Attachment D: Preferred ANR Use Agreement
Attachment E: Alternate ANR Use Agreement
ANR Incident Report
Any incident resulting in property loss/damage and/or causalities must be reported using this form.
Elective/Voluntary Activity Waivers
English and in Spanish covering liability issues for elective/voluntary events, including 4-H programs.
Organization of Self-Insured Schools (OSS)
Facilities Use Indemnification Agreement with the Division of Fairs and Expositions
Mutually agreed upon Hold Harmless and Indemnification language to be used in agreements at County and State Fair facilities.
Facilities Use Indemnification Agreement with the CSU
Mutually agreed upon Hold Harmless and Indemnification language to be used in agreements at CSU facilities.