1-ITB 26-405 Vendor Insurance Checklist.pdf

Title: Asphaltic Concrete Repairs (NCTS) Prepared: 2025 12 15 SWA Bid/Agreement No.: ITB 26-405

SWA Level 5b Risk Profile 7501 N. Jog Rd, West Palm Beach, FL 33412 REV 2025 12 12

Solid Waste Authority of Palm Beach County

INSURANCE REQUIREMENTS CHECKLIST

TYPE OF COVERAGE MINIMUM COVERAGE LIMITS

Must be included if marked.

“X”

Commercial General Liability

Bodily Injury & Property Damage $1,000,000. Per Occurrence $2,000,000. General Aggregate or CSL $2,000,000. Products – Comp/Op Aggregate

(Please note special instructions →) Silica product exclusion must be eliminated if cement/concrete materials are used during construction. Before accessing the SWA property or commencing activities under this agreement, the insured must provide the SWA with an acceptable certificate of insurance, including Additional Insured and Waiver of Subrogation endorsements. Minimum insurance coverage and limits marked on this list are required and must be no more restrictive than the most recent ISO forms. A certificate must include the current date and list the SWA as a Certificate Holder. The prime firm is responsible; insurance requirements extend to all employees and subcontractors.

Endorsements must be listed by form name and number, and copies provided. Additionally, the SWA may request copies of all policy documents.

X Occurrence Form

X Premises Operations

X Products-Completed Operations

X Contractual Liability

X Independent Contractors

X Personal Injury

Blasting

X Demolition

Watercraft – by exception for non-owned or Hull/ P&I (if used in the project)

Pollution extension, CPL, or separate EIL

Fire Legal Liability, not less than $100,000

Medical Payments, not less than $5,000

Automobile Liability Bodily Injury & Property Damage

$1,000,000. Combined Single Limit (Ea. accident)

$ 10,000. Personal Injury Protection (PIP)

X Any Auto Covered or Scheduled

X Non-owned/Hired (if no owned vehicles)

X

Workers’ Compensation Employer’s Liability

If required, F.S. Chapter 440/Federal Gov’t.

Statutory Limits $100,000. Occurrence $500,000. Aggregate $100,000. Disease

X Umbrella/Excess Liability $2,000,000. Occurrence

Professional Liability/Errors and Omissions $__________. Each Loss

Pollution Liability or Environmental Impairment Liability (EIL) or

Contractor Pollution Liability (CPL)

$__________. BI & PD Aggregate or CSL

Cyber Liability $__________. Each Loss

Builder’s Risk 100% of Value Property Under Construction

The SWA of Palm Beach County, its Officers, Employees, and Agents must be named as Additional Insured when permitted by law, and if applicable per F.S. 768.28, except for Workers’ Compensation and Employer’s Liability, Professional Liability, and Inland Marine. Vendors must use the following ISO form(s), or others approved by the SWA Risk Management that are no more restrictive than the most recent ISO forms:

Additional Insured Endorsement Form(s) CG2010, and CG2026. Must use ISO Waiver of Subrogation Endorsement CG2404 except for Workers’ Compensation, Professional Liability, and Inland Marine. Self-insured programs are subject to SWA Risk Management approval. Include the SWA agreement title, number, and specific description on the certificate. Provide a copy of all endorsements.