Research Corporation of the University of Hawaiʻi

Research Corporation
of the University of Hawai‘i
2.406 Statement of Self Insurance
If the RCUH is required to submit proof of insurance under a written agreement or contract, the State of Hawai‘i Department of Accounting and General Services (DAGS) will issue a Statement of Self-Insurance (SOSI) in lieu of an insurance policy. The State of Hawai‘i, with a few exceptions (i.e., federal government and county government), will not indemnify another entity nor list them as an additional insured on the State’s insurance policies. The DAGS SOSI will not be issued for dates more than one year from the request date.
I. Responsibilities
A. Principal Investigator
Prepare the request for a SOSI, attaching the written agreement or contract requiring the SOSI.
B. Fiscal Administrator
Work with the Principal Investigator and the Project Staff to ensure that the SOSI request is sufficiently detailed and submitted timely to RCUH Procurement.
II. Details of Policy
Provide the following information when requesting a SOSI to prevent any processing delays:
A. A detailed description of the activity involved, including how the activity relates to the business conducted by the department/division/branch.
B. Specific instructions regarding where the SOSI must be sent, including the complete name and mailing address of the entity or individual.
C. Date(s) of the activity or event.
D. For equipment, provide a description, the model/serial number, replacement value,
and location of the equipment, and identify any storage or security measures.
E. For premises, provide the building name (if applicable) and the complete address or location, such as a tax map key (TMK).
Submit the request to RCUH Procurement via a program’s respective Fiscal Administrator, and allow a minimum of seven (7) working days for a SOSI to be issued.

III. Relevant Documents
Policy 2.203 Vendor Terms and Conditions
UH AP 8.400 Risk Management Guidelines and Procedures
Date Revised: 2/02/2017