Fillable FPP ATTACHMENT G Final (University of Hawaii at Hilo)

Fill Online, Printable, Fillable, Blank FPP ATTACHMENT G Final (University of Hawaii at Hilo) Form

Use Fill to complete blank online UNIVERSITY OF HAWAII AT HILO pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

FPP ATTACHMENT G Final (University of Hawaii at Hilo)

On average this form takes 3 minutes to complete

The FPP ATTACHMENT G Final (University of Hawaii at Hilo) form is 1 page long and contains:

  • 0 signatures
  • 0 check-boxes
  • 12 other fields

Country of origin: US
File type: PDF

U.S.A. forms for University of Hawaii at Hilo

BROWSE UNIVERSITY OF HAWAII AT HILO FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
ATTACHMENT G
Request to Waive Insurance Coverage
In accordance with the University of Hawaii at Hilo, Agreement for Facility Use, all non-University
affiliated organizations utilizing facilities or grounds owned or operated by the University must provide a
certificate of insurance verifying the existence of the necessary liability coverage, including the coverage
of the University of Hawaii and the State of Hawaii, and their officers, employees, and agents.
The Chancellor or his/her designee who has jurisdiction over the subject facilities may waive this
insurance requirement, if necessary, when the activity serves the best interest of the University and
there is adequate showing of responsibility by the organization.
To be completed and submitted for approval by the scheduling officer:
Name of Organization:
Address:
Name of Responsible Person on the Day(s) of the
Event:
Email:
Phone:
Date(s) of Event:
Expected Attendance
Purpose of Event:
Room/Facility Requested:
Will alcohol be served?
Hours of Use:
Provide a detailed explanation regarding why the organization is requesting a waiver for insurance
coverage, to include 1) how the use of University facilities for the event serves the best interest of the
University; and 2) details demonstrating adequate responsibility by the organization:
Recommend approval: _____________________________ Date:___________________________
Scheduling Officer
Waiver for Insurance Coverage Approved Waiver for Insurance Coverage Denied
Reason denied:_______________________
____________________________________
__________________________________________ Date:_________________________________
Chancellor or Chancellor’s Designee
Revised 1/17
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

FPP ATTACHMENT G Final (University of Hawaii at Hilo)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 25 July 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document