Request_Form_Insurance_Exhibit_v2_2018_0001.pdf

National Park Service Insurance Consultation Services IDIQ Commercial Services Program Contract No.

v2.2018 For Internal Agency Deliberative And Analysis Purposes Only Not For Public Release 1

Commercial Services Program Prospectus Development

Insurance Requirements Request

Project Information

ConcID(s) : Submission Date Contract Category Prospectus Projected Release Date:

Prospectus Name:

Park:

Park District, if applicable:

State(s) or U.S. Territory:

WASO or Regional Project Manager’s Name, Phone Number and Email Address

Section I. Your Concerns and Questions Provide concerns and questions about operational aspects or the types of insurance for the operation.

Section II. Concession Operation

1. Concessioner’s Park Mailing Address with Zip Code. Where possible, provide the street address and zip code for the physical location(s) of the concession operation(s) within the park or GPS coordinates if an address is not available.

2. Internet Addresses.

• concessioner(s):

• Park:

3. Closest Fire Station with Address and Zip Code. For contracts with assigned concession facilities in the park, provide the address with zip code for the closest park or local community fire station, and the estimated distance(s) to the concession operation(s).

4. Services. Provide a table format with a comparison of the existing and proposed required and authorized services. Identify if the services are year-round or seasonal, address changes in services, and indicate required or authorized services.

For lodging provide 1) a breakdown by park location if the concessioner operates at more than one location and 2) the total number of rooms for each lodging building. For food and beverage provide 1) the number of seats for each area and 2) type of service such as table or counter. For tour boat and ferry operations, provide the average number of passengers per trip during the peak operating season.

For guided recreational activities, e.g., guided horseback rides, guided rafting trips, provide 1) the maximum number of trips per day, 2) the total number of guests and the total number of guides on an average trip, and 3) the guest to guide ratio.

5. Operational Characteristics, e.g., geography, river classification, seasonality, staff training that mitigates operational risk.

a) What is the park’s average river classification, Class I through V?

b) For contracts with assigned concession facilities and seasonal operations, does the concessioner have caretaker services?

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6. Concessioner Vehicles. Provide the number of vehicles by vehicle type and add other types, as applicable. A recent personal property report may be a source of information (see Section III).

Vehicle Type

Gross Vehicle Weight (GVW)

Number

Description of Use

Passenger Vehicles Light Pick-Up Trucks Under 10,000 Medium Weight Pick-up Trucks 10,000 –

20,000

Heavy Trucks 20,001 – 45,000

Extra Heavy Trucks Over 45,000 Trailers, e.g., utility, boat, horse Under 2,000 Trailers, e.g., utility, boat, horse Over 2,000 Buses (list passenger capacity for each)

Vans (list passenger capacity for each)

Golf Carts List other vehicles types separately

7. Small Boat Rental, if applicable. Break down rentals into size categories, as necessary.

Rentals

Maximum Fuel Capacity

Passenger Capacity

Without Motors

NA

With Motors – Under 21 feet and Under 26 hp

NA

With Motors – Over 21 Feet and/or Over 26 hp

8. Water Transportation Service, if applicable. What is the average ratio of passengers to captain and crew for each listed vessel?

Travel Location (inland, costal or international waters) or Name

Year Built

Appraised Value (for hull property insurance)

Weight/Gross

Tonnage Length & Width

Speed in

Knots

Fuel Capacity

Passenger

9. Aircraft Transportation Service, if applicable.

or Name

Aircraft Type

Built

Appraised Value (for hull property insurance)

Speed

Fuel Capacity

Maximum Passenger

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10. Does the concessioner operate an assigned aircraft landing and/or aircraft storage facilities for non-concessioner owned aircraft? If applicable, what is the estimated maximum value of all non-concessioner owned aircraft stored by the concessioner?

11. Aboveground and Underground Storage Tanks.

If applicable, provide information for each above and underground fuel storage tank for which the concessioner is responsible. You may attach an existing spreadsheet.

Type of Tank

Installed

Tank Capacity

Fuel Type, e.g., Diesel, Regular

Used for Visitor Fuel Sales?

Yes/No

Aboveground Underground

12. Does the concessioner hire professional services, e.g., dive instructor, massage therapist?

13. Does the concessioner hire security personnel? If applicable, provide the approximate number of personnel and the hours of operation.

14. Does the concessioner have an Internet retail and gift sales site? Are the appropriate IT controls in place to safeguard their internet sales transactions? If applicable, provide the website and the estimated annual gross receipts. The concessioner’s AFR may provide this information.

15. Does the concessioner hold special events, such as catered events or lectures? If applicable, describe the type of events. Is alcohol served or sold? Are fees charged?

16. For overnight accommodations, does the concessioner hold a guest’s personal property upon request, for the benefit of the guest? If applicable, what is the estimated maximum value of guest property held in the concessioner’s care, custody and control at any one time? If the concessioner provides several types of overnight accommodations, provide one estimated average value of held guest property. $

17. Does the concessioner operate RV Parks, campgrounds or comfort stations? If applicable, will the park assign a waste station in the new contract? Is the concessioner required to maintain and pump the waste station? What is the tank capacity?

18. If the concessioner operates a parking area, or vehicle or boat repair services in a building where fees are charged, address the following:

a) What is the estimated maximum value of all non-concessioner owned vehicles or boats held in the concessioner’s care, custody and control at any one time?

b) Provide the number of employees using the following table.

Class Description Number

Class I Employees

Full-time

Part-time (less than 20 hours per week)

Class II Non-Employees

Regularly provided an auto for operational use, e.g., volunteers

Under 25 years of age

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Section III. Financial Summary, Real and Personal Property

1. Historical Financial Summary. In a table format, provide the annual gross receipts by department for the past three years and the percentage of annual gross receipts by department.

Are there alcohol sales? If applicable, include the percentage of annual gross receipts for alcohol sales in food & beverage and merchandise. Provide the number of alcohol licenses.

2. Projected Annual Gross Revenue. Provide for the first year of operation:

a) The total projected revenue

b) The percentage of projected revenue by department If applicable, include the percentage of projected annual alcohol sales revenue.

3. Projected Annual Payroll for Workers’ Compensation (WC). For an estimated cost of WC, provide:

a) The projected annual payroll for the first year of operation

b) The payroll breakdown by WC class codes, or if not available, payroll breakdown by job description, e.g., cashiers, cooks, clerical, with the projected number of employees for each category (full-time and part-time)

Complete the following by department, e.g., housekeeping, maintenance.

Department Total Hours for all Hourly Employees Total Hours for all Salaried Employees Estimated Total Employee Hours

4. Real Property, if applicable. Provide the following information, a through i. Attach an up-to-date real property list from FMSS (Facility Management Software System) or a draft Assigned Land and Real Property Improvements exhibit. A Comprehensive Condition Assessment should have information about the building construction type and installed sprinkler systems.

a) Description

b) Construction type, e.g., wood, masonry, metal

c) Square feet

d) Date built or installed

e) Number of floors for a building if a multi-floor building

f) Building determined historic

g) Building with sprinkler system

h) Most recent Insurance Replacement Value (IRV)

i) Estimated value of all systems combined (HVAC, refrigeration, boilers, and major electrical panels) if valued over $50,000

For each area of operation

Concessioners may operate in a joint-use building where part of the building may function as a NPS visitor center or have NPS administrative offices. If applicable, provide the approximate percentage of the building(s) assigned to the concessioner. Will the park require the concessioner in the new contract to have property insurance coverage for the entire building or an assigned percentage?

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5. Personal Property Summary with Valuation. Provide a summary table or attach a current summary with the total estimated insurance replacement cost. Provide a separate subtotal for the value of vehicles and for equipment such as backhoes and lawnmowers.

6. Appraisal Valuations. If the concessioner operates a historic lodge, there may be NPS-assigned collectables such as fine art, furniture and rugs catalogued in a property appraisal spreadsheet with the insurance values. If applicable, attach with the most recent appraisal valuation and provide the estimated annual percentage of valuation increase. For tour vessel services, appraisals for existing vessels may be available.

Section IV. Insurance.

1. Exhibits and Certificates. Provide copies of the following:

a) Existing contract insurance exhibit (Exhibit I, F or D)

b) Concessioner’s current insurance certificates – ACORD 25 (liability) and ACORD 28 (commercial property for assigned concession facilities)

c) Workers’ Compensation certificate

d) If applicable, property certificate for hull insurance and professional liability certificate, e.g., hunting guides, massage therapists

2. Flood and Earthquake Insurance.

a) Are all or some of the assigned concession facilities located in a Special Flood Hazard Area?

b) Does the existing concessioner carry either flood or earthquake insurance?

c) Is flood or earthquake insurance required in the new contract?

3. Claim History. If known, provide:

a) Claim history for the past five years

b) Pending litigation

4. Insurance Premium Costs. Provide the available estimated insurance premium cost by the type of insurance coverage.

Insurance Type Estimated Premium Cost General Liability $ Auto Liability Liquor Liability Umbrella Liability Workers’ Compensation and Employers’ Liability Property Insurance Hull Insurance (vessels and aircraft) List other insurance

Section V. Proposed Concession Facility Improvement Program, if applicable.

Address total estimated value of improvements in the first year of operation, environmental compliance, anticipated impacts to operations, any affected capacity due to operational improvements, and projected project completion dates.

Section VI. Other Supporting Information. May include photos, diagrams and maps.