Certificate of Insurance Template for Vendors.pdf

Certificate of Insurance Template for Vendors Rev 5/18/2020 emahoney

A current certificate of insurance is required of all Contractors, Subcontractors, and Vendors before the commencement of services, as follows:

THE CERTIFICATE HOLDER SHALL BE:

IC 111 Building Company LLC, through its Manager, AmTrust Realty Corp. (“Owner”), 111 East Wacker Drive, Suite 1315, Chicago, IL 60601

THE ADDITIONAL INSURED SHALL BE:

• IC 111 Building Company LLC

• AmTrust Realty Corp.*

• IC Buildings Company LP*

• Wells Fargo Bank, N.A., as Master Servicer*

*their Successors and/or Assigns ATIMA.

Vendors and contractors performing work in Tenant space should include Tenant as Certificate Holder and/or Additional Insured as applicable.

CERTIFICATES SHOULD STATE THE FOLLOWING LIMITS OF COVERAGE:

• GENERAL LIABILITY:

COMMERCIAL GENERAL LIABILITY PER OCCURRENCE

EACH OCCURRENCE: $ 1,000,000

FIRE DAMAGE: $ 500,000

PRODUCTS & COMPLETED OPERATIONS $ 2,000,000 GENERAL AGGREGATE

MEDICAL EXPENSE: $ 10,000 (ANY ONE PERSON)

GENERAL AGGREGATE: $ 2,000,000

• AUTOMOBILE INSURANCE FOR BODILY INJURY AND PROPERTY DAMAGE FOR NOT LESS

THAN $ 1,000,000 COMBINED SINGLE LIMIT (MUST COVER ANY AUTO INCLUDING

HIRED AUTOS AND NON-OWNED AUTOS)

• UMBRELLA OR EXCESS LIABILITY COVERAGE IN AMOUNTS NOT LESS THAN

$ 5,000,000 PER OCCURRENCE.

• WORKERS COMPENSATION AND EMPLOYERS LIABILITY COVERAGE – A STATUTORY

WORKERS COMPENSATION POLICY COVERING EMPLOYEES IN THE STATE OF ILLINOIS

AND EMPLOYERS LIABILITY SUBJECT TO A LIMIT OF NO LESS THAN $500,000 EACH

Certificate of Insurance Template for Vendors Rev 5/18/2020 emahoney

EMPLOYEE, $500,000 EACH ACCIDENT, $500,000 POLICY LIMIT OR UNLIMITED IN NEW

YORK STATE.

• ALL-RISK, REPLACEMENT COST PROPERTY INSURANCE TO PROTECT AGAINST LOSS OF

OWNED OR RENTED EQUIPMENT AND TOOLS BROUGHT ONTO AND/OR USED ON ANY

PROPERTY BY THE SERVICE CONTRACTOR.

ALL POLICIES WILL BE WRITTEN WITH COMPANIES HAVING AN AM BEST’S RATING OF A-VIII

OR BETTER AND WILL PROVIDE FOR 30 DAYS ADVANCE NOTICE OF CANCELLATION OR NON-

RENEWAL TO OWNER. INSURANCE WILL BE PRIMARY AND NON-CONTRIBUTORY.

CONTRACTOR AND ITS SUB-CONTRACTORS SHALL, TO THE FULLEST EXTENT PERMITTED BY

LAW AND AT THEIR COST AND EXPENSE, DEFEND, INDEMNIFY AND HOLD THE INSURED, ITS

DIRECTORS, OFFICERS, EMPLOYEES, AGENTS AND REPRESENTATIVES HARMLESS FROM AND

AGAINST ANY AND ALL CLAIMS, LOSS (INCLUDING ATTORNEYS FEES, WITNESS FEES AND ALL

COURT COSTS) DAMAGES, EXPENSE AND LIABILITY RESULTING FROM INJURY AND OR DEATH

OF ANY PERSON, OR DAMAGE TO OR LOSS OF ANY PROPERTY ARISING OUT OF ANY NEGLIGENT

OR WRONGFUL ACT, ERROR, OMISSION OR BREACH IN CONNECTION WITH THE OPERATIONS

OF CONTRACTOR AND SUB-CONTRACTOR, AND ITS EMPLOYEES, AGENTS AND

REPRESENTATIVES.

PLEASE EMAIL TO THE ATTENTION OF:

ILLINOISCENTER@AMTRUSTRE.COM

PLEASE MAIL ORIGINALS TO: IC 111 Building Company LLC, c/o AmTrust Realty Corp.

111 East Wacker Drive. Suite 1315 Chicago, IL 60601

The Tenant and their General Contractor is responsible for coordinating all insurance certificates for all Subcontractors and Vendors prior to mobilization. Failure to comply with any of the insurance provisions noted above will result in a breach of contract by Contractor/sub-contractors and Contractor/sub-contractors will not be allowed to start work.