Risk Identification and Evaluation
The campus must determine if the activity or risk is one that may warrant departure from the regular insurance
requirements. The following information must be provided:
E
vent/Activity/Contract:
Date(s): Start/End Time:
Location:
Contract/Agreement Amount:
Description of Event/Activity/Contract:
Please answer all of the following questions (indicate N/A for those not applicable).
1. What activities will take place?
2. How many attendees are expected?
3. W
ho could be harmed? Will the public be involved? Will minors be present?
4. What property could be damaged and to what degree?
College/Division:
Telephone/Ext.:
Department:
Department Contact Information:
Name/Title:
Email Address:
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Event/Activity/Contract: _________________________________________________
2
5. Are crowds or bystanders/passersby likely to be involved?
No: _____
Yes/Possibly, please explain:
6. Will inherently dangerous activities be involved?
No: _____
Yes, please explain:
7. Will alcohol be served?
Yes No
8. Is there a possible pollution (air, soil, water) exposure?
No: _____
Yes/Possibly, please explain:
9. How likely is it that the University will be a defendant in the event of a loss?
10. Is there a reputational risk to the University?
No: _____
Yes, please explain:
11. Is this a recurring (annual) special event? If “yes” what is the safety/loss history of the event?
No: _____
Yes:
Department Administrator Comments:
Name/Title Signature/Date
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Event/Activity/Contract: _________________________________________________
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Evaluator Comments:
What is the maximum likely loss for this activity?
Name/Title Signature/Date
Director, Risk Management/Environmental Health and Safety Comments:
Name/Title Signature/Date
*Vice President for Administration and Finance and CFO, or designee, Comments:
Name/Title Signature/Date
* Certain cases may require approval by the Vice President for Administration and CFO, or designee, (to be determined on a case-by-case basis).
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