4-4663 - Letcher County - Insurance Coverage Declaration (1).pdf

This is an Insurance Coverage Declaration form required by Letcher County, Kentucky for contractor proposals related to Appraisal Review Services for a Floodplain Acquisition Project. Contractors must provide proof of comprehensive insurance coverage and submit copies of all relevant policies with endorsements to avoid proposal rejection. The declaration requires contractors to document three types of insurance: Commercial General Liability with a $2,000,000 aggregate limit and $1,000,000 per occurrence limit, Comprehensive Automobile and Water Vehicle Liability with a $1,000,000 combined single limit per occurrence for any auto, and Worker's Compensation with employer's liability coverage of at least $1,000,000 per occurrence for each accident or illness. Additionally, contractors must provide Physical Damage Insurance covering owned or rented machinery, tools, equipment, office trailers, and vehicles.

The Worker's Compensation policy must include a provision requiring thirty days' written notice to the County before any cancellation or material modification. Firms with owner-operators who have filed a "Notice of Election to be Exempt" must supply a signed copy of that notice, provided the exemption meets applicable Worker's Compensation law requirements. Contractors must complete the declaration form by documenting the insurance carrier, type of coverage, policy limits in dollars, and expiration dates for each required insurance category. Failure to properly complete and attach all insurance documentation as specified may result in rejection of the proposal.