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The University Release and Indemnification Agreement is to be used by non-University groups (hereafter referred to "Organization") using University facilities to protect the University from liability.
The issuing office is responsible for completing all fill-and-print form fields located at the top of the University Release and Indemnification Agreement and the Campus/College Contact information at the bottom of the agreement prior to sending to Organization for signature.
The Organization requesting use of University facilities must return the signed University Release and Indemnification Agreement along with the Certificate of Insurance to the Campus/College contact person listed at the bottom of the agreement, using the Contact Person PSU Email.
The issuing office must forward a copy of the signed agreement along with the Certificate of Insurance to psucontracts@psu.edu at least two (2) weeks prior to the date of the event. The issuing office retains the original and the Organization's Certificate of Insurance.
Please contact Risk Management with any insurance questions for non-University groups.
Refer also to Policies:
This form has fill-and-print form fields and digital ID (signature) fields enabled. The PDF version has instructions provided for the type and/or format of information to be included within the fill-and-print form fields. Hovering the computer mouse over any form field within the PDF will display these instructions. See Converting Web-based Documents to PDF Documents for details. See Applying Digital IDs on PDFs (general instructions) for instructions on adding signatures
For step-by-step instructions on completing the University Release and Indemnification Agreement, click on link below:
University Release and Indemnification Agreement Exhibit
No form may be used that substitutes for an approved official University form without prior review and approval by the steward of the form/central office, as facilitated by the Office of Systems and Procedures (designated representative of the Associate Vice President for Budget and Finance). See Policy FN17 Required Use of Approved University Forms Appearing in the General University Reference Utility (GURU) for full details.
GURU PDF forms are designed for use with Adobe Acrobat Reader or Adobe Acrobat Pro. Each browser (Chrome, Firefox, Internet Explorer, etc) has a built-in PDF viewer making it the default PDF viewer without asking users. These built-in viewers do not necessarily support all features required for PDF Forms. Similarly, many calculations are not supported by other stand-alone PDF readers (for example, Nuance). If you experience problems downloading or opening documents, right click on the link on the Forms Locator Screen, select 'Save Link As' (or similar language) and save the file. The document can then be opened in either Adobe Acrobat Reader or Adobe Acrobat Pro from the saved location.
The latest version of Adobe Acrobat Reader is available for free. Contact your IT support staff person for downloading assistance, if/as needed. An Adobe Creative Cloud (CC) account is also available to all Penn State students, faculty, and staff members, at no cost. Sign up for an Adobe Creative Cloud account at adobe.psu.edu. If Adobe Acrobat Pro better suits your needs, contact your IT support staff person for purchasing and installation assistance.
Clicking the form download icon on any of the form instruction pages on GURU will open a web-based version of the form. While it appears to have fill-and-print fields available, not all functionality may be available for use (i.e. digital ID fields). With some exceptions (see below), it will be necessary to convert these web-based documents to PDF documents.
In order to have a version with all PDF capabilities enabled, click the "Fill & Sign in Acrobat" or "Open with Acrobat" icon located in the upper right-hand corner of the screen. This icon must be clicked before entering any information. A new versions of the document will open. Complete this version and save the document in a location where you will be able to locate it.
If, upon opening the PDF in Google Chrome, the Fill & Sign in Acrobat icon does not appear in the upper right-hand corner of the screen, it will be necessary to enable Adobe Acrobat extension. Please visit Enable Adobe Acrobat extension for Google Chrome for instructions to enable Adobe Acrobat extension.
There may be times when it is necessary to combine multiple PDF documents into a single document for submission. In those instances, complete the following steps:
Repeat this process for each document that will be combined (each file name must be different from the previous)
This form has the Digital ID (applying an electronic signature to the document) process enabled. If, upon opening the PDF in Google Chrome, the following does not appear in the upper right-hand corner of the screen, it will be necessary to enable Adobe Acrobat extension
Please visit Enable Adobe Acrobat Extension for Google Chrome for instructions to enable Adobe Acrobat Extension.
This form has the "Clear Form" Bookmark enabled. To clear ALL form fields:
If you encounter any difficulties, contact the GURU support staff by submitting a Technical Support form request or by calling the tech support line at 814-863-8592.
Document: | Ultimate Distribution: | Retention Periods: | Disposition Method: |
---|---|---|---|
Original and Organization Certificate of Insurance | Issuing Office | End of fiscal year +2 years | Paper document = Secure Bin disposal or shred Electronic Document and Data = delete and empty computer recycle bin |
Copy* | Contract Review Team in Procurement Services | End of fiscal year +2 years | Paper document = Secure Bin disposal or shred Electronic document and data = delete and empty computer recycle bin |
*Transitory/Disposable Records are University Records that have temporary value and, as a result, may be destroyed after they are no longer needed. In no event shall be retained longer than the official copy of the University Records as delineated on the Records Retention Schedule.
The issuing office emails a copy of the completed, signed agreement along with the Organization's Certificate of Insurance to psucontracts@psu.edu at least two (2) weeks before the scheduled event. The issuing office is responsible for retaining the official University Record (original agreement and the Organization's Certificate of Insurance) as stated in the distribution table (above).
For questions, additional detail, or to request changes to this form, contact psucontracts@psu.edu.
(2/15/2022)