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Docusign Envelope ID:C19AABC9-9198-4469-BDOC-21C1 1 NUMB <br /> ADDENDUM A <br /> UNIVERSITY" OF CALIFORNIA <br /> PROOF OF SELF-INSURANCE COVERAGE <br /> The Regents of the University of California are often requested by outside parties to provide evidence <br /> of the University's self-insurance coverage in conjunction with agreements and contracts negotiated <br /> by its employees on UC campuses and medical centers. Examples of situations where the University <br /> may be required to provide evidence of insurance include: <br /> • Using an off-campus location to host an event, ceremony, athletic event,theatre production, <br /> practice space,job fair, educational outreach event, etc. <br /> Leasing or renting equipment, motor vehicle(s), or real estate <br /> • Research grant sub-awards <br /> • Affiliation(non-healthcare/medical related) and Professional Services Agreements <br /> The University of California self-funds its liability exposures, so does not issue individual certificates <br /> of insurance. The UC Office of Risk Services has developed a Certificate of Self-Insurance Coverage <br /> document(COC) to illustrate the self-funded retention levels maintained for each liability program. <br /> The COC is available on-line for use by entities conducting business with the university as evidence <br /> of the self-funded retention levels, coverage terms, and limits routinely requested.The self-insurance <br /> limits accepted in each Specific written agreement or contract shall be the limits that apply should a_ <br /> loss arise, regardless of the limits provided in the on-line Certificate of Self-insurance Coverage <br /> document. <br /> The UC COC Site is solely for the use and benefit of the vendors and organizations which contract <br /> with the University of California and not for resale or other transfer to or use by or for the benefit of <br /> any other person or entity. You may print copies for use within your organization, provided that you <br /> do not modify the COC in any way, nor distribute any copies outside your organization. You may not <br /> use any of the University of California's names or marks in any manner that creates the impression <br /> such names or marks belong to or are associated with you or imply any endorsement by the University <br /> of California, and you acknowledge that you have no ownership rights in and to any of these names or <br /> marks. You will not use the Site, the information contained therein or any of the University's names or <br /> marks in unsolicited mailings or spam material. You may not link directly to the COC ("deep link") or <br /> bring up or present the COC or other content of this site within another web site ("frame"). <br /> Official Correspondence must be sent via postal mail to: <br /> Chief Risk Officer <br /> Office of Risk Services <br /> Office of the President <br /> University of California <br /> I I I 1 Franklin St., 6th Floor <br /> Oakland, CA 94607-5200 <br /> 510-987-9832 <br /> RiskServices@ucop.edu <br /> Please contact the local Risk Manager at the specific University of California location where you are <br /> contracting if you have insurance coverage questions: <br /> • Campus Risk Mana ers Directory <br /> • Hos ital Risk Managers Directory <br />