6-2026-21 Sample COI.pdf

Town of Fairfield Sullivan Independence Hall 725 Old Post Road Fairfield, CT 06824

X X

X X

Project Name:

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 Liability SAMPLE x x x x X X x x x

Insurance Agent Contact

1,000,000

1,000,000

1,000,000

3,000,000

500,000

500,000 500,000

100,000 5,000 1,000,000

2,000,000

Pollution Liability $1,000,000Policy Number (s) Effective Effective Date (s) Date (s)

CA 9948 Endorsement

2026-21 Police Vehicle Upfit

Professional Liability

A. General Requirements

The additional insured protection afforded The Town of Fairfield, Fairfield Board of Educations, its officers, officials, employees, and agents, Boards and Commissions must be on a primary and non-contributory basis except Workers Compensation and Professional Liability (Errors and Omissions). All policies must include a waiver of subrogation in favor of The Town of Fairfield, Fairfield Board of

Educations, its officers, officials, employees, and agents, Boards and Commissions.

All of the carriers that provide the below required insurance must be rated “A-:VII” or better by A.M.

Best and must provide direct written notice of cancellation or non-renewal to The Town of Fairfield, Fairfield Board of Educations, its officers, officials, employees, and agents, Boards and Commissions at least 30 days before such cancellation or non-renewal is effective, except for cancellations due to non-payment of premium, in which case 10 days written notice is acceptable.

B. Insurance Requirements for the Selected Contractor

The selected Contractor will be required to obtain and provide proof of the types and amounts of insurance listed below: (i) as a condition precedent to the award of the contract for the Project; and (ii) continuing throughout the entire Term. The insurance policies listed below must also conform to the applicable terms of the Contract.

• Commercial General Liability Insurance, written on ISO Form CG 00 01 or its equivalent and with no modification to the contractual liability coverage provided therein, shall be provided on an occurrence basis and limits shall not be less than:

o $1,000,000 per occurrence o $2,000,000 general aggregate o $2,000,000 products / completed operations aggregate

The Town of Fairfield, Fairfield Board of Educations, its officers, officials, employees, and agents, Boards and Commissions must be protected as additional insureds on ISO Form CG 2010 (11/85) or its equivalent on policies held by the selected Contractor and any of its subcontractors. Should the

Contractor’s work include construction activities of any kind then the Contractor must maintain Products

/ Completed Operations coverage for no less than three years after the construction work is completed, and continue to include Additional Insured protection for The Town of Fairfield, Fairfield Board of

Educations, its officers, officials, employees, and agents, Boards and Commissions for the prescribed timeframe. Securing the required limits via a combination of primary and umbrella/excess liability policies is allowed. The General Aggregate limit must apply on a per project basis on the primary General

Liability policy should a combination of primary and Umbrella/Excess liability policies be utilized to secure the required total limits of coverage.

• Automobile Liability Insurance with a combined single limit of not less than $1,000,000. Coverage must apply to the Contractor’s owned, hired, and non-owned vehicles and protect The Town of

Fairfield, Fairfield Board of Educations, its officers, officials, employees, and agents, Boards and

Commissions as additional insureds on a primary and non-contributory basis. Contractor shall obtain and maintain ISO Form CA9948 on the Automobile Liability policy (Pollution Liability Broadened

Coverage for Business Automobile). The Automobile Liability policy must include a waiver of subrogation in favor of The Town of Fairfield, Fairfield Board of Educations, its officers, officials, employees, and agents, Boards and Commissions.

• Workers’ Compensation, Employer’s Liability, and Disability Benefits shall not be less than statutory limits, including United States Longshore and Harbor Workers Act coverage as applicable to the operations of the Contractor. The Workers’ Compensation policy must include a waiver of subrogation in favor of The Town of Fairfield, Fairfield Board of Educations, its officers, officials, employees, and agents, Boards and Commissions.

• Pollution Liability shall be provided and must be maintained at a limit of not less than $1,000,000 each occurrence and $1,000,000 in the aggregate. The Town of Fairfield, Fairfield Board of Educations, its officers, officials, employees, and agents, Boards and Commissions must be protected as additional insureds on a primary and non-contributory basis. The Pollution Liability policy must include a waiver of subrogation in favor of The Town of Fairfield, Fairfield Board of Educations, its officers, officials, employees, and agents, Boards and Commissions.

• Professional Liability (Errors and Omissions) shall be provided and must be maintained at a limit of not less than $1,000,000 per claim and $1,000,000 in the aggregate. The Professional Liability

(Errors and Omissions) must include a waiver of subrogation in favor of The Town of Fairfield, Fairfield Board of Educations, its officers, officials, employees, and agents, Boards and Commissions.

• Umbrella or Excess Liability shall be provided and must be maintained at a limit of not less than

$3,000,000 per occurrence. Umbrella or Excess Liability must be on an occurrence basis. The Town of

Fairfield, Fairfield Board of Educations, its officers, officials, employees, and agents, Boards and

Commissions must be protected as additional insureds on a primary and non-contributory basis. The

Umbrella or Excess Liability policy must include a waiver of subrogation in favor of The Town of

Fairfield, Fairfield Board of Educations, its officers, officials, employees, and agents, Boards and

Commissions.

C. Insurance Requirements for all Subcontractors

Any subcontractor(s) utilized by the selected Contractor will be required to obtain the types and amounts of insurance listed below: (i) as a condition of commencing any Work; and (ii) continuing throughout the duration of such subcontractor’s Work. The insurance policies listed below must also conform to the applicable terms of the Contract.

• Commercial General Liability Insurance, written on ISO Form CG 00 01 or its equivalent and with no modification to the contractual liability coverage provided therein, shall be provided on an occurrence basis and limits shall not be less than:

o $1,000,000 per occurrence o $2,000,000 general aggregate o $2,000,000 products / completed operations aggregate

The Town of Fairfield, Fairfield Board of Educations, its officers, officials, employees, and agents, Boards and Commissions must be protected as additional insureds on ISO Form CG 2010 (11/85) or its equivalent on policies held by all subcontractors. Should the subcontractor’s work include construction activities of any kind then the subcontractor must maintain Products / Completed Operations coverage for no less than three years after the construction work is completed and continue to include Additional Insured protection for The Town of Fairfield, Fairfield Board of Educations, its officers, officials, employees, and agents, Boards and Commissions for the prescribed timeframe. Securing the required limits via a combination of primary and umbrella/excess liability policies is allowed. The General Aggregate limit must apply on a per project basis on the primary General Liability policy should a combination of primary and Umbrella/Excess liability policies be utilized to secure the required total limits of coverage.

• Workers’ Compensation, Employer’s Liability, and Disability Benefits shall not be less than statutory limits, including United States Longshore and Harbor Workers Act coverage as applicable to the operations of the subcontractor. The Workers’ Compensation policy must include a waiver of subrogation in favor of The Town of Fairfield, Fairfield Board of Educations, its officers, officials, employees, and agents, Boards and Commissions.

• Subcontractors will also be required to obtain all other insurances listed in Section (2) unless otherwise approved in writing by The Town of Fairfield prior to commencement of any

Subcontractor’s work.