4-4663 - Letcher County - Insurance Coverage Declaration.pdf

This is an Insurance Coverage Declaration form for Letcher County Fiscal Court in Kentucky, detailing mandatory insurance requirements for contractors bidding on hazardous materials inspection services at two residential properties acquired through a voluntary property buyout grant program. Prospective contractors must submit completed insurance documentation with their proposals or risk rejection. The declaration requires contractors to provide proof of three primary types of insurance coverage: Commercial General Liability with minimum limits of $2,000,000 aggregate and $1,000,000 per occurrence, with the General Aggregate limit applying separately to the resulting contractor or equaling at least twice the occurrence limit; Comprehensive Automobile and Water Vehicle Liability covering any automotive equipment used in service performance with minimum limits of $1,000,000 per occurrence combined single limit for any auto, plus Physical Damage Insurance for owned or rented machinery, tools, equipment, office trailers, and vehicles; and Worker's Compensation with employer's liability coverage of not less than $1,000,000 per occurrence for each accident or illness.

The Worker's Compensation policy must include a provision that it cannot be cancelled or materially changed without thirty days' prior written notice to the County. Contractors 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 all applicable Worker's Compensation law requirements. Proposers must complete the insurance declaration form listing each insurance carrier, type of coverage, policy limits in dollars, and policy expiration dates, attaching all insurance policies including endorsements to substantiate compliance with these requirements.