DEC-1

Acknowledgment of Legal Liability Protection

EMPLOYEE: _______________________ Date of Hire: __________________

            I am a newly hired employee of the District and have received from the District a disclosure of insurance coverage which is provided to employees through the Utah State Risk Manager.  I state that I have read the disclosure prepared and provided through the Risk Manager through the School District office.  I further state that I understand legal liability protection provided to me and what is not covered, as explained in the disclosure.

            Unless indicated below, I have no questions or uncertainty about liability protection coverage.

Dated this ____ day of ________, 20___.

Employee:

_________________________________

Witness:

___________________________________

Utah Code Ann. § 63A-4-204. 

Utah Code Ann. § 53A-3-411.