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Forms

 

Accident/Incident Report Form
Use this form to document an accident or incident occurring on campus, during a University-sponsored event, and/or while driving a University Insured Vehicle (see TAP 38). Employee accidents/incidents should also be reported to Melody Cook, 412.396.6677.

Certificate of Insurance Requests for Former Students Related to Potential Employment
Employers may request that former students provide them with a Certificate of Insurance evidencing University insurance coverage during the former student's time as a University student (also called "evidence of coverage"). This is most often requested by employers in the medical field. Use this form to request a Certificate of Insurance related to potential employment.

Certificate of Insurance Requests for University Departments and Organizations
It is common for a non-affiliated individual or organization to request a Certificate of Insurance related to off-campus rentals, events, etc. (also called "evidence of coverage"). A Certificate of Insurance is proof of insurance coverage. Use this form to request a Certificate of Insurance unrelated to potential employment. Upon request, you will be asked to confirm the existence of a contractual relationship between the University and the non-affiliated individual or organization.

Auto Accident Form
Regardless of damage, all drivers operating a University Insured Vehicle (see TAP 38) must report all accidents to the Office of Risk Management. The information requested on this form will enable the Office of Risk Management to report auto claims to the University's insurance carrier. In most cases, individuals who are completing the Auto Accident Form should also complete an Accident/Incident form, especially if there are injuries involved.

Application for Driving Privileges
In accordance with TAP 38, any University student, faculty, or staff member who wishes to operate a University Insured Vehicle must complete this form and meet all associated requirements before being permitted to drive. Type your information, then print and sign. (Please note, if you are using Mozilla Firefox as your web browser, download the form first.)