The forms below are used for various Drake approved activities. The forms need to be completed and forwarded to the risk management contact, Donna Blunck. The forms should be submitted in a timely manner to allow ample time to review and run approvals (as necessary).
Risk Management and Insurance Forms and Uses (Downloadable)
1. Certificate of Insurance Request(COI). These forms are used to request certificates of insurance from vendors for Facility Rentals, Services <$25,000, Contracts, Events, Chartered Rentals, Sport Camps, etc.
Certificate of Insurance Request Forms:
2. Voluntary Domestic Trips. Used for various events, such as, class trips, mock trials, moot court, workshops, debates, etc.
All trips--voluntary or not--should have the participant emergency contact information readily available and an identified faculty or staff emergency contact on notice for the trip.
3. International Trips. Used for those traveling on behalf of Drake to a foreign country. MEDEX is part of the university’s group travel insurance. It provides travel assistance, medical evacuation, repatriation, etc. The Roster needs to be filled out to register the trip participant(s) for the insurance. The Medex Traveler documents summarize what services (paid for and not paid for) are provided. This insurance is at no cost to the participant.
MEDEX Roster Form (Trip Leader fills out and emails to Donna Blunck ): MEDEX Roster and for the traveler’s use:Medex Traveler Documents
4. Incident or Accident Report.
Used for incidents that do not have a security incident report filed. Use for slips, falls, thefts, vehicle accident, property damage.
Incident Form: Incident (Accident Injury Incident Reporting Process); Vehicle Accident Report form
NOTE: Faculty, staff, or student employee falls or injuries are workers comp related. Those injuries are to be reported through Blueview HR Forms portal. Form is found under Employee Tab titled: First Report of Injury.
5. Insurance Card. Used for vehicle rentals and Drake owned vehicles.
Insurance Card Form: Insurance Card
6. Motor Vehicle Report (MVR). Used for Drake Driver Approval—Process: a motor vehicle report is run. All Drake approved drivers must have 6 or less mvr points based on the Motor Vehicle Points List.
Driver Approval Forms: Motor Vehicle Request and Motor Vehicle Point System
7. Release of Liability (ROL). Used for various events--on campus, off campus, debates, field trips, mock trials, moot court, competitions, personal vehicle use, personal property on campus, etc.