1-4663 - Letcher County - Insurance Coverage Declaration.pdf
PDF 623 KB Posted
- Attached to
- Letcher County Blackey Water Plant Demolition Request for Bid - Demolition Services - R-5
- Solicitation number
- Demo - 5 - Template 1
- Issued by
- Larue County, Kentucky
About this file
This is an Insurance Coverage Declaration form from the Letcher County Fiscal Court's Property Buyout Program, located in Kentucky. The document outlines specific insurance requirements for contractors participating in the program, mandating three types of comprehensive insurance coverage: Commercial General Liability (with $2 million aggregate and $1 million per occurrence), Comprehensive Automobile and Water Vehicle Liability (covering automotive equipment with a $1 million combined single limit), and Worker's Compensation (with employer's liability coverage of $1 million per occurrence).
The form requires contractors to complete and attach detailed insurance policies with all endorsements to their proposal, with a warning that failure to do so may result in proposal rejection. Specific stipulations include that the Worker's Compensation policy must provide 30 days prior written notice before cancellation or material changes, and firms with owner/operators who have filed for Worker's Compensation exemption must supply a signed copy of their notice of election. The document provides a table for contractors to fill in their insurance carrier details, coverage types, coverage limits, and expiration dates.
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Other files
| File | Type | Posted |
|---|---|---|
| 2-Letcher County Blackey Water Plant Demolition RFB Final as of 10 28 25.pdf |
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Text version
INSURANCE COVERAGE DECLARATION
Contractor shall complete the form below and attach the following insurance policies (including all endorsements) to this proposal. Failure to do so, may result in a rejected Proposal.
1. Commercial GeneralLiability–intheamountoftwomilliondollars($2,000,000.00)aggregate/one million dollars ($1,000,000.00) per occurrence. The General Aggregate limit shall either apply separately to the resulting Contractor or shall be at least twice the required occurrence limit.
2. ComprehensiveAutomobileandWaterVehicleLiability–coveringanyautomotiveequipmenttobe used in performance of the service, with a minimum limit in the amount of One Million Dollars ($1,000,000.00) per occurrence combined single limit / any auto. Physical Damage Insurance covering owned or rented machinery, tools, equipment, office trailers, and vehicles.
3. Worker’s Compensation – Proposer shall provide a policy with employer’s liability coverage with limits of not less than One Million Dollars ($1,000,000.00) per occurrence for each accident or illness. The Worker’s Compensation policy shall state that it cannot be cancelled or materially changedwithoutfirstgivingthirty(30)dayspriornoticethereofinwritingtotheCounty.Firmsthat haveowner/operatorsthathavefileda“NoticeofElectiontobeExempt”shallsupplyasignedcopy ofsaidnotice.Anysuchexemptionshallmeettherequirementsthatualifyforanexemptionunderthe applicable Worker’s Compensation law.
Insurance Carrier Type of Coverage Limit ($) Expiration Date
General Liability
Commercial Auto
Worker’s Compensation
File details come from the government source that posted it. Updated .