Insurance and Risk Management -2022

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Vehicle Forms and Programs

You may download the STD 261, 262, 269, 270, and 274 forms from the State of California Office of State Publishing (OSP) forms website by entering the form number. However, you can only download these forms if you have the recommended version of Adobe Acrobat Reader. A description of the various vehicle-related forms and their purpose is as follows.

STD 261 - Authorization to Use Privately Owned Vehicle on State Business - Employee

This certification verifies the employee's private vehicle has the minimum amounts of liability insurance coverage, is in safe mechanical condition, and is adequate for use in accordance with the State Administrative Manual (SAM) section 0753. This form advises the State employee that adequate vehicle insurance coverage must be provided by the employee's personal insurance and that personal vehicle insurance is primary coverage in case of a vehicle accident.

The supervisor authorized to approve travel shall retain the STD 261 completed authorization form in the employee's personnel file. The authorization form is valid for a period not to exceed one year. Once the STD form 261 is completed, it may be initialed and dated annually by the employee to certify adequate personal auto insurance is current and that the private vehicle is safe for state business use.

STD 269 - Accident Information Card Form

When the driver of a University or State-owned vehicle is involved in an accident, he/she must record all pertinent information on the Accident Information Card form STD 269 before leaving the scene of the accident. Blank STD 269 cards should be readily available in the glove compartment of each State (rental, owned, leased, or private) vehicle. When another vehicle is involved in an accident with a State vehicle, the appropriate portion of the STD form 269 is completed, detached, and given to the driver of the other vehicle. The State Office of Risk and Insurance Management (ORIM) is the University's third-party auto insurance provider.

STD 270 - Vehicle Accident Report Form

All motor vehicle accidents involving a State-owned vehicle or any vehicle being used on State business must be reported on the Vehicle Accident Report (STD 270) form within 48 hours to the State Office of Risk and Insurance Management (ORIM). If the accident results in bodily injury or significant property damage, the accident must be first reported by telephone and/or fax a copy of the STD 270 to the ORIM fax phone number at (916) 322-6006.  

STD 274 - State Driver Accident Review Form

The supervisor of each driver involved in an accident must prepare a State Driver Accident Review form STD 274 to investigate the accident promptly and thoroughly. The supervisor must initiate any verbal or written corrective action; record the action, and forward copies of the completed form to the appropriate campus administration (the CSUN Office of Safety and Risk Management). The purpose of this report is to determine whether the accident was avoidable and to aid in the prevention of future accidents. This State Driver Accident Review (STD 274) must be submitted with the Vehicle Accident Report (STD 270) filed with the State Office of Risk and Insurance Management (ORIM) as well as your Campus Risk Manager.

Student Authorization - Authorization to Operate Privately Owned Vehicle - Student

To be completed when a student will operate a private vehicle on a university-sponsored trip/activity.

Powered Cart Training Certification - Employee/Supervisor Training Certification

Every powered cart or low-speed vehicle driver must be certified before driving.

CSUN Vehicle Use Policies - Vehicle Usage Policy

Policy 450-01 from the Office of the Vice President for Administration and Finance, issued 11/08/04 and currently in effect.

CSU Department of Motor Vehicles Pull Notice Program- DMV Pull Notice Program

There is a CSU requirement to verify the California driving records of all State employees authorized to drive on State business.  The Department of Public Safety under the direction of the Chief of Police administers this program.