Fillable Get File Group Id 9027836 (California Maritime Academy)

Fill Online, Printable, Fillable, Blank Get File Group Id 9027836 (California Maritime Academy) Form

Use Fill to complete blank online CALIFORNIA MARITIME ACADEMY pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

Get File Group Id 9027836 (California Maritime Academy)

On average this form takes 16 minutes to complete

The Get File Group Id 9027836 (California Maritime Academy) form is 2 pages long and contains:

  • 0 signatures
  • 36 check-boxes
  • 46 other fields

Country of origin: US
File type: PDF

U.S.A. forms for California Maritime Academy

BROWSE CALIFORNIA MARITIME ACADEMY 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
 
California State University Maritime Academy
Risk Identification and Evaluation Form
This Section to be Completed by the Buyer
Project:
Contract/Req. # :
Contractor/Vendor:
Buyer’s Name:
Extension:
Date of
Request:
The followin
g risk identification and evaluation form is provided in compliance with Technical Letter re: California State University
Insurance Requirements, RM 2012-01 to identify and document insurance review and/or waiver for purposes of campus related
activities or purchases. NOTE: Please be sure to submit a copy of the requisition, (signed) contract, and/or backup documentation
with the RI&E Form prior to the commencement of the performance of any contractual obligations or dispatch of a Purchase
Order and ensure payment of any vendors.
I. Detailed descri
ption of Activities, including frequency, dates, and location:___________________________________________
_________________________________________________________________________________________________________
________________________________________________________________________________________________________.
II. Type of Contract
*:
Minor Projects (under $610K)
Major Projects
$610K to $2 million
$2 to $5 million
$5 to $10 million
Over $10 million
Scope of Work
Public Works Service Architect and Engineering
HazMat Projects up to $5,000,000
Public Works Service in Support of Construction Projects
HazMat Projects over $5,000,000
Written Service Agreements or Signed Orders (Non Public Works)
Facility Use Agreements
III. Additiona
l Factors for Consideration (check all that apply):
Chancellor’s Office Contract in
Place for Activity
IT Agreements involving
Financial Transactions
Lasers, X-ray producing equipment,
and gas compression systems
SRMReview Confirmed
IC Agreement if no Automatic Waiver
Applies**
(Engineering, Architectural)
Agreements involving
sensitive data (cyber risk, crime
bond)
Rev 02/16
Purchase Order without Written Agreement
IV
. Identification of insurance requirements not met (briefly explain):
Insurance Limits Not Met
Insurance Coverage Not Present
Additional Insured Endorsement:
Blanket Auto
Missing Auto
Blanket GL
Missing GL
Other
Umbrella is being used to cover/meet GL/PL Limits
Insurance Rating (Below A-VIII)
Other (i.e. PO name doesn’t match COI, dates for PO activity are not covered in term of COI as provided, etc.)
V.
Requestor Information (from Department):
Requestor’s Name
Extension
e-mail
VI. Reco
mmendation of Buyer (optional):__________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
________________________________________________________________________________________________.
This Section to be Completed by the Department of Risk Management
VII. Reco
mmendation of Risk Manager:___________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
University Risk Manager or Designated Representative
Date
*All contract types, for insurance purposes, are outlined in Technical Letter re: California State University Insurance Requirements
Approved
Not Approved
Returned for Additional
Review/Information
Notification of Defect and Commentary
(Event has passed)
Rev 02/16
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

Get File Group Id 9027836 (California Maritime Academy)

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 16 July 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document