Please print and return this completed form together with proof of insurance coverage to Dr. Jeffrey Corney, Associate Director, Cedar Creek Ecosystem Science Reserve, 2660 Fawn Lake Drive NE, Bethel, MN 55005.
1. Insurance Required for Non-University of Minnesota Employees. If you are not a University of Minnesota employee, the University requires that you provide “Proof of General Liability Coverage”* if you are to live at Cedar Creek or otherwise regularly work at Cedar Creek. Note that, according to University policy, we cannot allow you to live at Cedar Creek unless you provide this. It should be routinely issued by your home university, we are told. We are sorry for the inconvenience.
*“The University of Minnesota requires proof of Commercial General Liability (CGL) coverage in the amount of $1,000,000 (per occurrence) Combined Single Limit. Along with this requirement, the Regents of the University of Minnesota should also be named as an Additional Insured to this policy.”
2. Name:__________________________________________________________
3. What projects will you be working on this summer?
4. What dates will you be working at Cedar Creek? _____________________________
5. Are you a University of Minnesota researcher? __________
6. If you are not a University of Minnesota researcher, and are funded by a grant that does not pay overhead to the University of Minnesota, you need to pay $200/week for site and facility use. If you are working independently, not funded by a grant, the site-use fee does not apply. Please note that this fee is charged in lieu of the overhead funds that research grants otherwise would generate. Direct support from the University of Minnesota (some of which is derived from overhead) and support from site-use fees provides the only funds for maintaining our roads, buildings, grounds and infrastructure. Granting agencies regularly approve the payment of such site-use fees.
7. Indicate what dates you would like to stay at Cedar Creek. Dates:____________________ to __________________
8. Do you need desk space? ________ When?_________________________to_______________________
9. Do you need lab space? _________ When?_________________________to_______________________
10. What do you need in lab? (sink, hood, etc.) _____________________________________________________________________
11. Do you need storage space (area)? _________________________________________
12. Number of assistants you will have?_______________________________________ Names:______________________________________________________________
13. What dates will assistants be at Cedar Creek? Dates:____________________ to __________________
14. Dormitory space or other housing is extremely limited at Cedar Creek. Please preferentially hire assistants who can commute to Cedar Creek. As possible, we will try to accommodate the housing needs of those who cannot commute. Please indicate what dates they would like to stay at Cedar Creek.
Name:________________________________ Dates:__________________to__________________
Name:________________________________ Dates:__________________to__________________
Name:________________________________ Dates:__________________to__________________
Name:________________________________ Dates:__________________to__________________
Name:________________________________ Dates:__________________to__________________
15. Describe additional space/equipment needs. Please note that we do not have any approved animal holding/handling facilities at Cedar Creek:
________________________________________________________________________
Please print and return this completed form together with proof of insurance coverage to Jeffrey Corney, Associate Director, Cedar Creek Ecosystem Science Reserve, 2660 Fawn Lake Drive NE, Bethel, MN 55005.