Loss Prevention Information and Forms
Automobile Certificates of Self-Insurance
- Certificate for Archidiocese of Detroit Parish or Institution Vehicles2022–2023
- Certificate for Diocese of Gaylord Parish or Institution Vehicles2022–2023
- Certificate for Diocese of Grand Rapids Parish or Institution Vehicles2022–2023
- Certificate for Diocese of Kalamazoo Parish or Institution Vehicles2022–2023
- Certificate for Diocese of Lansing Parish or Institution Vehicles2022–2023
- Certificate for Diocese of Marquette Parish or Institution Vehicles2022–2023
- Certificate for Diocese of Saginaw Parish or Institution Vehicles2022–2023
Equipment Breakdown and Boiler Inspections
After many years of partnering with Hartford Steam Boiler (HSB) for our equipment breakdown insurance and certified state boiler inspections, the MCC has entered into an agreement with Chubb Insurance Company. As of July 1, 2022, Chubb handles all our boiler inspections with the exception of our properties within the city of Detroit. If your boiler equipment needs inspection, you can either request one through Chubb’s online request form (you will need our policy number of 76442168) or contact our dedicated Chubb Risk Engineer Joel Ingersoll at (414) 477-0661 or jingersoll@chubb.com.
For assistance with operation of your boiler equipment, Chubb has provided the helpful documents listed below that may be useful to you.
- Boiler Operating Log
- Combustion Control Devices
- Efficient and Safe Heating Boiler Operation Practices
- Installing A New Boiler
- Internal Inspection Overview
- Preparing for Internal Boiler Inspections
Emergency Planning
- Bomb Threat Procedures
- Church Emergency Operations Plan Template
- Cyber Security — Best Practices
- Emergency Procedure Flipchart Template
- Suspicious Mail Poster
- Threatening-call Report Form
- Tornado Safety Tips
Employment/Employee
- Labor Law Workplace Poster Requirements
- Required Labor Laws (Contains 14 posters)
- EEOC Poster
- Families First Coronavirus Response Act Poster
- Family & Medical Leave Act Poster (English)
- Family & Medical Leave Act Poster (Spanish)
- Federal Minimum Wage Poster
- Michigan Whistleblower Act Poster
- MIOSHA Poster (English)
- MIOSHA Poster (Spanish)
- Paid Medical Leave Act Poster
- Polygraph Act Poster (English)
- Polygraph Act Poster (Spanish)
- USERRA Poster
- Michigan Minimum Wage and Overtime Poster
- Non-discrimination poster (Arabic)
- Non-discrimination poster (English)
- Non-discrimination poster (Spanish)
- SDS Location Poster
- SDS Poster
- Unemployment Security Act
- Youth Employment Act
- Volunteers: A Guideline to Allowable Duties
- Youth Employment
Facility Management
- Confined Space Entry
- Information on Pesticide Control
- Knights of Columbus Use of Church Facilities
- Liquor Liability Exposures and Controls
- Control of Hazardous Energy Sources (Lockout/Tagout)
- Pesticide Application Parent Notification Form
- Rental Agreement and Policy
- Renovate Right: Important Lead Hazard Information for Families, Child Care Providers, and Schools
- Security Latch Products Handout
- Self-inspection Program
- Small Entity Compliance Guide to Renovate Right: EPA’s Lead-Based Paint Renovation, Repair, and Painting Program
- Snow/Ice Removal Log
- Third Party Vendors
- Underground Storage Tanks (UST): FAQ
- Underground Storage Tanks (UST): Registration and Instructions
- Use of Church Facilities
- Public Water Supply Testing
- Winter Weather: Checklist
- Winter Weather: Ice Storm Power Failures
- Winter Weather: Presentation on Preparing for Winter Weather
- Winter Weather: Preventing Snow Load Roof Collapse
Field Trip Policy
- Field Trip Policy Packet (Contains all four forms listed below)
- Field Trip Policy Summary
- Field Trip Parent Permission Form
- Field Trip Medical Treatment Release Form
- Field Trip Volunteer/Employee Driver Information Sheet
Health
- 2019 Novel Coronavirus
- 2019 Novel Coronavirus Frequently Asked Questions
- Bloodborne Pathogens Standard
- First Aid Cabinet and Portable Kit Recommendations
- Hepatitis B Vaccination Record or Declination Statement
- OSHA Handbook for Pandemic Influenza
Michigan Right-To-Know Law (MRTKL)
- Michigan Right-To-Know Law Fact Sheet
- Safety Data Sheets (chemicalsafety.com)
- Safety Data Sheets (msdsonline.com)
- SDS Written Hazard Communication
- SDS Request Letter
Playground Equipment
- Playground Equipment Handout
- Playground Monthly Safety Checklist
- Handbook for Public Playground Safety
- Tips for Public Playground Safety
School Bus
- Driver Record Request Form
- Information on Requesting a Driver’s Record
- Information on ‘S’ Endorsement for School Bus Drivers
- School Bus Recorded Pre-trip Inspection Form
School Specific
- Athletic Participation Parent Permission Form
- Chemical Lab Guidelines
- MIOSHA Chemical Hygiene Plan
- School Personnel Guide for Reporting Suspected Child Abuse and Neglect
- Student Accident / Injury Reporting Forms Flow Chart
- Student Accident Report
- Renewal of Student Accident Medical Coverage
- Student Medication Log