Statement of Self Insurance
If you are required to provide a Statement of Self Insurance to a vendor, contractor, or other entity for any reason, please submit an Assistance Request Form (PDF) with the following information:
- Statement Holder (name, address)
- Start/End Date of Contract/Agreement/Activity
- Description of activities
- For equipment leases: Model Number, Serial Number, Description and Dollar value
- Attach copy of Contract/Agreement/Application Form/Permit/License/Other
Please allow at least 10 days for processing.
The State Risk Management and Insurance Administration program (Risk Management Program) provides both liability and physical damage coverage (comprehensive/collision and fire/theft) for University-owned and leased vehicles.
- Comptroller’s Memorandum 2009–03, dated January 20, 2009 (PDF)
- UH Administrative Procedure No. A8.400, dated August 2002 (PDF)
The State Risk Management and Insurance Administration program (Risk Management Program) provides insurance coverage for University-owned property, and property in the care, custody and control of UH.
Vice Presidents and Chancellors are responsible for determining the nature and extent of insurance coverage necessary for their respective programs. The Office of Risk Management is responsible for processing the purchase of all insurance policies for compliance with University purchasing requirements. All insurance purchases should be routed to the Office of Risk Management via KFS.
Third Party Minimum Insurance Requirements
The Office of Risk Management recommends that third parties who will be performing work or providing services to the University; or using University facilities be required to carry certain types of insurance coverage at specified minimum limits:
- Commercial General Liability (bodily injury and property damage; personal and advertising injury; contractual liability, products and completed operations): $1 million combined single limit per occurrence, $2 million aggregate
- Worker’s Compensation: contractors and suppliers should carry limits complying with Hawaiʻi law
- Automobile Liability (if the outside party uses a vehicle that is integral to work performed or will be operating a vehicle on UH property): $1 million combined single limit (SCL) each occurrence, to include either “ANY AUTO” or “SCHEDULED, HIRED, OWNED, NON-OWNED AUTOS”
- Professional Liability (when a supplier has a professional designation or license and/or is providing professional services): $1 million per claim, $2 million annual aggregate (will vary by project)
- The type and minimum amounts of insurance coverage required may vary based on the type of work performed, service provided or activity. The University reserves the right to require higher limits or additional types of insurance from a contractor or vendor for a particular project or event.
Certificate of Insurance
A Certificate of Insurance is a document that provides information about insurance policies. Generally speaking, certificates list one or more lines of insurance, the limits associated with these coverages, and the insurer providing coverage.
- Third parties who are required to carry insurance should provide a duly executed Certificate of Insurance evidencing the requisite types and limits of insurance no less than one week prior to the date of event/contract/service.
- Each certificate shall specify that the policy cannot be cancelled before the expiration date thereof and notice will be delivered in accordance with the policy provisions, that the University of Hawaiʻi and State of Hawaiʻi are named as additional insureds, that the insurer waives any subrogation rights against the University of Hawaiʻi and State of Hawaiʻi, and that any insurance maintained by the University of Hawaiʻi and/or the State of Hawaiʻi will apply in excess of, and not contribute with, insurance provided by this policy.
- Certificate of Insurance Guide.