Form EEADA-E-2 - Use of School Busess/Insurance Coverage

EEADA-E-2 - USE OF SCHOOL BUSES BY SCHOOL DISTRICT GROUPS

INSURANCE COVERAGE

Fill out and submit to Transportation Supervisor to request use of a district bus.

 

Limits of liability are:

$ ______bodily injury

$______ property damage

$ ______medical payments

 

Group Name: ___________________________ Today's Date:________________

Contact Person: __________________________Phone #:____________________

Date of Requested Bus Use:______________________

 

Purpose:

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

 

· I have read policy EEADA and rule EEADA-R and will comply with such.

· I have completed and returned Hold Harmless Agreement EEADA-E-2 to the Transportation Supervisor.

· A copy of the group's certificate of insurance covering auto and general liability, with minimum coverage, as shown above, is attached forthcoming.

· The School District of Altoona is listed as an additional insured on the group's insurance.

 

Signed:_________________________________

 

Approved: 04/20/98

To print this policy, highlight the text, go to File, Print, and choose "selection" for your print range.