13.07.2015 Views

APRC 120202 appendix 2 (PDF - 958KB) - University of Birmingham

APRC 120202 appendix 2 (PDF - 958KB) - University of Birmingham

APRC 120202 appendix 2 (PDF - 958KB) - University of Birmingham

SHOW MORE
SHOW LESS
  • No tags were found...

You also want an ePaper? Increase the reach of your titles

YUMPU automatically turns print PDFs into web optimized ePapers that Google loves.

Appendix OneUNIVERSITY OF BIRMINGHAM - STUDENT PLACEMENT FORM OF INDEMNITY(not for use where student is undertaking a placement in a company)Institution providing placement ___________________________________________Name <strong>of</strong> Student___________________________________________Duration <strong>of</strong> Placement From ___________________________________________To___________________________________________Placement Provider’s Declarationa) We have a written Health and Safety Policyb) We confirm we have undertaken a risk assessment <strong>of</strong> our work practices to identify,minimise and/or eradicate possible risks to the student and that we will provide anappropriate induction to the student to minimise these risksc) We confirm we have in force Employer’s and Public liability insurances and that the studentand/or accompanying teacher is deemed to be an employee for the purposes <strong>of</strong> theseinsurance policiesd) We confirm we have advised appropriate insurers <strong>of</strong> the proposed placement(s)e) Should the student be expected to work with machinery, equipment or substanceshazardous to health safety precautions will first have to be taken, first aid facilities will beavailable and training, supervision and protective clothing will be providedf) We will keep all personal data confidential in accordance with the UK Data Protection Act1998 or equivalent legislationSigned on behalf <strong>of</strong> the institution providing placementNamePosition Held___________________________________________________________________________________________________________________________The <strong>University</strong> agrees to indemnify the placement provider ______________________and its Servants and Agents against claims for damages, loss, costs and expenses incurred as aresult <strong>of</strong> bodily injury to persons &/or damage to material property arising out <strong>of</strong> any negligent act oromission <strong>of</strong> such Student(s) in the course <strong>of</strong> the placement period.PROVIDED that:a) notice in writing shall be given to the <strong>University</strong> <strong>of</strong> <strong>Birmingham</strong> as soon aspracticable <strong>of</strong> any action or claim brought or made or threatened against you andthat you shall not settle adjust or in any way compromise such action or claimwithout the <strong>University</strong>’s consent.b) this indemnity will not apply to the extent that such liability results from anyact or neglect <strong>of</strong> the Placement Provider its Servants or Agents.Signed on behalf <strong>of</strong> <strong>University</strong> <strong>of</strong> <strong>Birmingham</strong>Name /Position ____________________________________Date____________________________________

Hooray! Your file is uploaded and ready to be published.

Saved successfully!

Ooh no, something went wrong!