SOP 215.14-att-1: Waiver of Liability

Division:
Facilities
Effective Date:
January 6, 2022
Reference Code:
IID04-0012
Topic Area:
215 Policy-Transitional Center
PowerDMS:
View on PowerDMS
Length:
123 words

Summary

This form documents permission for an employee to drive a company vehicle for work-related purposes at a transitional center. It establishes that the State of Georgia assumes no liability for accidents involving the vehicle and requires the employer to maintain appropriate insurance coverage. The completed form is filed in the resident's case file.

Key Topics

  • waiver of liability
  • company vehicle
  • employee driver
  • insurance coverage
  • transitional center
  • accident liability
  • vehicle authorization
  • employer responsibility

Full Text

SOP 215.14
Attachment 1

01/06/22

# GEORGIA DEPARTMENT OF CORRECTIONS Waiver of Liability

To Whom It May Concern:

_____________________________, your employee has permission to drive a company
vehicle as needed for your work when this form is signed and returned to my office.

The State will not be liable for accidents. Therefore, your company must be responsible
for insurance coverage. Please list below the name of your insurance company and the
amount of coverage you have on the vehicle(s) the employee will drive.

Sincerely,

______________________________
Superintendent

Name of Insurance Company: _________________________________________

Address: __________________________________________________________

__________________________________________________________

Amount of Type/Coverage: ___________________________________________

Name of Firm: _____________________________________________________

_______________________________________ __________________
Signature of Employer Date

Retention Schedule: Upon completion, this form shall be placed in the Resident’s case file and maintained
according to the official retention schedule for that file

Attachments (2)

  1. Waiver of Liability (123 words)
  2. Authorization for Use of Company Vehicle by Resident (131 words)
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