1、Driver Certification for Business Use of Vehicle(s) See Instructions on page 3.Return To:Human Resources & Risk Management SDSU Research Foundation5250 Campanile DriveSan Diego, CA 92182-1945Project:Supervisor:Phone: I hereby certify that, whenever I drive an SDSU Research Foundation (SDSURF) owned
2、vehicle or a privately owned vehicle on SDSURF business:1. I will have a valid drivers license in my possession in accordance with California State law,2. The vehicle will be covered by liability insurance for at least the minimum amount prescribed by California law. I will have a current vehicle re
3、gistration and proof of insurance in the vehicle at all times while driving, as required by Vehicle Code Section 16020.3. I will carry only passengers who are also on SDSURF business,4. The vehicle will be equipped with safety belts in good operating condition and all passengers will be required to
4、wear them,5. The vehicle will be appropriate for the work performed, and6. To the best of my knowledge, the vehicle will be in safe mechanical condition as required by law.I further certify that, while using any vehicle for official SDSURF business, all accidents will be reported within 24 hours to
5、the SDSURF Risk Management Office at (619) 594-0858. I understand that permission to drive a vehicle on SDSURF business is a privilege, which may be suspended or revoked at any time, and that driving a personal vehicle on SDSURF business without meeting the requirements as stated above is considered
6、 a violation of SDSURF policy and may be grounds for disciplinary action, up to and including termination of employment.Section A - Choose the applicable driving option from the following:?I will never drive any vehicle on SDSURF business. (If checked, proceed to and complete Section C)?I will drive
7、 less than 2 times per week and agree to provide proof of insurance. (If checked, proceed to and complete Sections B and C)?I will drive on SDSURF business as part of my job at least 2 times per week and agree to provide proof of insurance, or I will drive a 10, 12 or 15 passenger van, can provide p
8、roof of Class B license, and agree to provide proof of insurance. (If checked, proceed to and complete Sections B, C and D)Section B: License and insurance information:Drivers License Number:State:Expiration Date:Insurance Carrier Name:Policy Expiration:Policy Number:Policy Period:Section C. Employe
9、e acknowledgment:Acknowledgment - If requested I agree to provide my current Motor Vehicle Record to SDSURF within 3 working days.Employee Signature:Date:Print Name and Red ID:Date Section D: Authorization for release of information:Employer Pull Notice Program Authorization for Release of Driver Re
10、cord InformationI hereby authorize the California Department of Motor Vehicles (DMV) to disclose or otherwise make available, my driving record, to my employer, San Diego State University Research Foundation (SDSURF).I understand that my employer will enroll me in the Employer Pull Notice (EPN) Prog
11、ram to receive a driver record report at least once every twelve (12) months or when any subsequent conviction, failure to appear, accident, drivers license suspension, revocation, or any other action is taken against my driving privilege during my employment.I am driving in a capacity that requires
12、 enrollment in the EPN Program pursuant to California State University Risk Management Authority (CSURMA) Policy and Procedure 1-AOC. I understand that enrollment in the EPN program is an effort to promote driver safety, and that my driver license report will be released to my employer to determine
13、my eligibility as a licensed driver for my employment. Executed at City:County:State:Date:Employee Signature:For HR Use Only:Proof of insurance verified:?Yes?NoDMV Report Requested:?Yes?NoDate Requested: DMV Employee Pull Notice Program/Automobile Insurance and the Use of Vehicles on SDSU Research F
14、oundation BusinessCalifornia State University Risk Management Authority (CSURMA) policies and procedures require SDSU Research Foundation (SDSURF) to provide them with documentation that all employees who drive vehicles on SDSU Research Foundation business hold a valid drivers license. Also required
15、 is documentation that individuals who use their own vehicles maintain current primary automobile coverage on that vehicle. This requirement applies whether the individual is driving their own vehicle only occasionally on SDSU Research Foundation business or whether driving their vehicle is a requir
16、ement of their SDSU Research Foundation employment.Additionally, CSURMA policy requires SDSURF to enroll employees who drive on SDSURF business more than once a week or whose primary duty is driving-related in the Department of Motor Vehicles Employee Pull Notice Program (DMV-EPN). This includes whe
17、ther driving an SDSU Research Foundation owned vehicle or a privately owned vehicle on SDSURF business.DMV Employee Pull Notice Program The DMV-EPN Program allows SDSURF to monitor the driver license records of employees who drive on behalf of SDSURF. The EPN Program generates a driver record 1) upo
18、n enrollment in EPN program, 2) from the date of enrollment on an annual basis or 12 months from the last action/activity printout, and/or 3) whenever a driver has any of the following actions/activities added to his/her driver record:1. Convictions, 2. Failures to appear,3. Accidents,4. Driver lice
19、nse suspensions or revocations or, 5. Any other actions taken against the driving privilege.Driving Standards as a Condition of EmploymentDrivers on SDSURF business will have no more than three (3) driving record points for moving violations (speeding, failure to stop, etc.), no major violations in
20、the previous three (3) years (reckless driving, etc.), or must not have been convicted of any alcohol-related or drug-related driving offense during the past three (3) years. These provisions apply even if the driving which result in acquiring the violation points was not in the course of employment
21、.Please be aware that should your driving record change and a major violation (i.e., driving with a suspended license, driving while intoxicated, reckless driving, etc.) occurs you may be classified as an unacceptable driver and may not be allowed to drive on SDSURF business. If driving is a job req
22、uirement, you must immediately inform your supervisor and the Director of Human Resources & Risk Management. Failure to report a serious change in your motor vehicle record may result in disciplinary action, up to and including termination of your employment.Out of State DriversIf another state repo
23、rts action/activity to California on out-of-state licensed drivers or California licensed drivers, it will be stored on the driver record and reported to SDSU Research Foundation.Required DocumentationEmployees classified as occasional drivers (less than 2 times per week), must present the documenta
24、tion listed below:?A valid California drivers license or equivalent to legally operate the class of vehicle(s) they operate in their employment.?If permitted to use a personal vehicle in the course and scope of employment, proof of personal automobile liability coverage that meets Californias minimu
25、m requirements. If not accessible, the individual will have 3 business days to provide such proof.An employee who is driving more than once a week on SDSURF business or whose primary duty is driving related is classified as a non-occasional driver and will be required to present an acceptable Motor
26、Vehicle Record (MVR) prior to employment. Additionally, any individual driving a vehicle designed, used, or maintained for carrying more than 10 persons, including the driver for the purpose of transporting passengers on SDSURF business must possess a class B drivers license with a passenger endorse
27、ment, and will be subject to random drug testing in accordance with the Omnibus Transportation Act of 1991 and must comply with additional State and Federal regulations.Automobile InsuranceYou must carry liability insurance on your personal automobile at least in the minimum amounts required by Cali
28、fornia State law. If you are involved in an accident while on SDSURF business, your own personal automobile insurance will be primary in the event of a loss. SDSURFs insurance coverage is only applicable if the liability exceeds your personal liability insurance coverage. It is suggested you also ca
29、rry automobile physical damage comprehension and collision insurance sufficient to cover the reasonable value of the vehicle, less a standard deductible. SDSURFs insurance does not cover loss or damage to your vehicle, nor your deductible.It is the normal practice of insurance carriers to allow occa
30、sional use of privately owned vehicles on business trips without an increase in premium rates. Please check your vehicle insurance policy for specific coverage provided. If your vehicle is used consistently on SDSURF business, you should contact your insurance carrier who may require a change in the
31、 risk class upon which your premium is calculated and this may result in a premium increase.Driver Requirements/Use of Vehicles While on SDSU Research Foundation Business?You must have a valid drivers license in your possession in accordance with California State law. ?You must be covered by liabili
32、ty insurance for at least the minimum amount prescribed by State law. You must have a current vehicle registration and proof of insurance in the vehicle at all times while driving. Vehicle Code Section 16020 (effective July 1, 1985) requires all motorists to carry in the vehicle evidence of financia
33、l responsibility in effect for the vehicle. ?While on SDSURF business, you should carry only passengers in the vehicle who are also on business with you. No friends, relatives or children should be in the vehicle while you are driving on SDSURF business. No exceptions! ?Vehicle should be adequate fo
34、r the work performed and must be in safe mechanical condition as required by law. ?Vehicle must be equipped with safety belts in good operating condition and all persons in the vehicle must be required to wear them. ?If you are in an accident while on SDSURF business, you must complete a Vehicle Acc
35、ident Report and report the accident within 24 hours to the SDSURF Risk Management office at (619) 594-0858.Travel into Mexico on SDSURF Business Requires Additional Proof of InsuranceBefore driving your personal vehicle, or an SDSURF vehicle, into Mexico on SDSURF business, all employees are requir
36、ed to purchase Mexican Auto Physical Damage and Liability Insurance, for the duration of their travel, from a reputable insurance company. SDSURF employees must also keep copies of the policy, and a receipt for purchase of the insurance while in Mexico and be able to submit copies to SDSURF Risk Man
37、agement upon request.IMPORTANTAll SDSURF employees are required to sign the ”Driver Certification for Business Use of Vehicle(s)” form in order to meet the requirements of CSURMA policies and procedures. We will continue to ask you to provide us with updated information on an annual basis and apprec
38、iate your cooperation in doing so. If you currently do not own a car or drive your own car or a rental car on SDSURF business, please indicate that on the form. Please be aware that driving your own personal vehicle on SDSURF business without meeting the requirements as stated above is considered a
39、violation of SDSURF policy and may be grounds for disciplinary action, up to and including termination of your employment. (Driver Certification for Business Use of Vehicle(s) form begins on page 1.)Driver Certification for Business Use of Vehicle(s) 驱动程序认证业务的车辆(s使用) See Instructions on page 3. 见第3页
40、说明。 Return To: 返回到: Human Resources & Risk Management 人力资源及风险管理 SDSU Research Foundation SDSU研究基金会 5250 Campanile Drive 5250钟楼驱动器 San Diego, CA 92182-1945 加利福尼亚州圣迭戈92182-1945 Project: 项目: Supervisor: 主管: Phone: 电话: I hereby certify that, whenever I drive an SDSU Research Foundation (SDSURF) owned ve
41、hicle or a privately owned vehicle on SDSURF business: 我在此证明,当我驾车一SDSU研究基金会(SDSURF)自备车辆 , 或对SDSURF民营汽车企业: I will have a valid drivers license in my possession in accordance with California State law, 我将在我在美国加利福尼亚州依法拥有有效的驾驶执照, The vehicle will be covered by liability insurance for at least the minimu
42、m amount prescribed by California law. I will have a current vehicle registration and proof of insurance in the vehicle at all times while driving, as required by Vehicle Code Section 16020. 这款车将责任保险覆盖至少受加利福尼亚州法律规定的最低数额。我将在车辆的驾驶时,如车辆需要法第16020次 , 目前所有车辆登记和保险证明。 I will carry only passengers who are al
43、so on SDSURF business, 我会继续谁上SDSURF业务也只乘客, The vehicle will be equipped with safety belts in good operating condition and all passengers will be required to wear them, 这款车将配备安全带的良好运作状态 , 所有乘客必须穿, The vehicle will be appropriate for the work performed, and 这款车将适当完成的工作,和 To the best of my knowledge, t
44、he vehicle will be in safe mechanical condition as required by law. 据我所知,将在汽车安全机械状况所要求的法律。 I further certify that, while using any vehicle for official SDSURF business, all accidents will be reported within 24 hours to the SDSURF Risk Management Office at (619) 594-0858. I understand that permission
45、 to drive a vehicle on SDSURF business is a privilege, which may be suspended or revoked at any time, and that driving a personal vehicle on SDSURF business without meeting the requirements as stated above is considered a violation of SDSURF policy and may be grounds for disciplinary action, up to a
46、nd including termination of employment. 我还证明,虽然使用任何官方SDSURF商务车,所有的事故报告将在24小时内(619)594-0858向SDSURF风险管理办公室。据我所知 , 允许驾驶的车辆上SDSURF业务是一种特权,这可能会被暂停或撤销在任何时间,而驾驶SDSURF业务不作为上述会议被认为是SDSURF违反政策 , 并可能采取纪律行动的理由,直至并包括终止雇用的要求 , 一辆私人汽车。 Section A - Choose the applicable driving option from the following: A节-选择从以下适用
47、的驱动选项: I will never drive any vehicle on SDSURF business. (If checked, proceed to and complete Section C) 我绝对不会推动任何SDSURF商务车。(如果选中,开始并完成C节) I will drive less than 2 times per week and agree to provide proof of insurance. (If checked, proceed to and complete Sections B and C) 我将驾驶少于每周2次 , 并同意提供保险证明。(
48、如果选中,开始并完成第B和C) I will drive on SDSURF business as part of my job at least 2 times per week and agree to provide proof of insurance, or I will drive a 10, 12 or 15 passenger van, can provide proof of Class B license, and agree to provide proof of insurance. (If checked, proceed to and complete Sections B, C and D) 我将驾驶SDSURF业务 , 作为我工作的一部分 , 至少每星期2次 , 并同意提供保险证明,否则我将驾驶10,12或15个客运车,可以提供B级许可证明,并同意提供保险证明。(如果选中,开始并完成第B,C和D) Section B: License and insurance information: B节: