3-2026-13 Professional Liability - COI Template.pdf
PDF 462 KB Posted
- Attached to
- Employee Benefits Consultant
- Solicitation number
- 2026-13
- Issued by
- Fairfield County, Connecticut
About this file
This document is an ACORD Certificate of Liability Insurance for the Town of Fairfield and Fairfield Board of Education, associated with RFP #2026-13 for an Employee Benefits Consultant. The certificate outlines comprehensive insurance coverage requirements for a professional services contract, including commercial general liability, automobile liability, umbrella liability, and professional liability (errors and omissions) insurance. The insurance policies provide various coverage limits, with general liability set at $1,000,000 per occurrence and $2,000,000 aggregate, and professional liability coverage of $5,000,000 each occurrence and in the aggregate.
The certificate specifies that the Town of Fairfield, Fairfield Board of Education, its officers, officials, employees, agents, boards, and commissions are included as additional insured on most insurance policies, with a primary and non-contributory basis. The insurance policies include a waiver of subrogation and require thirty (30) days prior written notice of cancellation (ten days for non-payment of premium). The document serves as a standard insurance verification form, ensuring that the contracted vendor maintains appropriate insurance coverage for the proposed professional services engagement.
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Text version
Town of Fairfield Sullivan Independence Hall 725 Old Post Road Fairfield, CT 06824
X X
X X
RFP #2026-13 Project Name: Employee Benefits Consultant
The Town of Fairfield, Fairfield Board of Educations, its officers, officials, employees, and agents, Boards and Commissions are included as additional insured for all insurance policies except Workers Compensation & Professional Liability, on a primary and non-contributory basis. All policies include a waiver of subrogation in favor of the certificate holder. Thirty (30) days prior written notice of cancellation will be given to the Town (Ten (10) days for non-payment of premium).
Insurance Agent Name and Address
Vendor/Contractor Name/Address/Contact
Vendor/Contractor Insurance Companies Enter NAIC #
Month/Date/Year
Policy Number
Policy Number
Policy Number
Policy Number
Effective
Date
Date
Date
Date
Date
Date
Date
Date
Signature
Effective
Effective Effective
Effective Effective
Effective Effective
Professional Services SAMPLE x x x x X X x x x
Insurance Agent Contact
1,000,000
2,000,000
1,000,000
2,000,000
500,000
500,000 500,000
100,000 5,000 1,000,000
2,000,000
$5,000,000 each occurrence/ $5,000,000 aggregatePolicy Number (s) Effective Effective
Date (s) Date (s)
CA 9948 Endorsement
Professional Liability (Errors & Omissions)
File details come from the government source that posted it. Updated .