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 vendors (third parties who will be performing work or providing services to the University), exhibitors, and external users of University facilities be required to carry certain types of insurance coverage at specified minimum limits:
- Commercial General Liability: $1 million each occurrence, $2 million general aggregate (coverage must be provided for bodily injury liability, property damage liability, personal & advertising injury liability, and products & completed operations coverage); $100,000 Damage to Rented Premises (ea occurrence). The policy must cover liability arising out of an insured contract (contractual liability)
- Worker’s Compensation: contractors and suppliers should carry limits complying with Hawaiʻi law
- Employer’s Liability: $500,000 Bodily Injury – Each Accident; $500,000 Disease – Policy Limit; $500,000 Disease – Each Employee
- 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: should the policy be cancelled before the expiration date thereof, notice will be delivered to the University in accordance with the policy provisions; that the University of Hawaiʻi and State of Hawaiʻi are named as additional insureds on General Liability, Automobile Liability, and Umbrella/Excess Liability Policies (in the absence of an agreement or contract with the third party, the University will require a copy of the actual endorsement to the policy); that the insurer waives any and all 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 Sample
- Insurance Agreement