City_Required_risk-checklist-construction.pdf

Edition 04/2025

Risk Management ∙ Construction Checklist

DEPARTMENT TO COMPLETE ALL FIELDS ON THIS PAGE.

Low – Med High Risk – UPDATE INSURANCE TRANSMITTAL WITH CHECKLIST INSURANCE REQUIREMENTS DETAILED BELOW, THEN SEND COMPLETED INSURANCE

TRANSMITTAL TO BUYER WITH YOUR BLANKET CONTRACT REQUEST OR REQUISITION

High Risk - SEND COMPLETED CHECKLIST to Risk Management for additional insurance assessment:

(Bruce.Hori@seattle.gov ∙ Courtney.Beauchene@seattle.gov ∙ Samantha.Anderson@seattle.gov)

PROJECT NAME: CONSULTANT NAME: DEPARTMENTAL CONTACT: DEPT/DIV: TEL EXT:

SUMMARY OF SCOPE OF WORK [Including contract value]:

RISK ELEMENT LOW MEDIUM MEDIUM HIGH

HIGH

CONTRACT VALUE

Up to $500K $500K-$3M $3M-$10M >$10M

MARITIME

None in NavWa NavWa X-Divers NavWa Including Divers

WATERCRAFT

*NavWa=Navigable Waterways

None <26ft X-NavWa* 46-65ft or Incl NavWa NavWa Including Divers

AIRCRAFT None/Commercial Fixed-wing, Chartered Helicopter, Single-day UAV/Drone

Multiple-day Chartered Helicopter Multiple-day UAV/Drone

PROFESSIONAL SERVICES**

*Architectural/engineering (A/E), environmental, geotechnical, real estate, medical, laboratory, surveying, mapping, software development, Construction Management/Administration (CM/CA) or high-level Technical Strategic Management Consulting

None <$5M contract value Any Professional Services w/ contract value >$5M

MOTOR VEHICLES

None used Autos*/Small Trucks Large Trucks/Trailers

Up to heavy vehicles and mobile equipment, excluding large earthmovers or cranes

Oversized vehicles used, including large earthmovers or cranes

ENVIRONMENTAL

*Resource Conservation and Recovery Act (1978)

No RCRA levels* Some RCRA level Truckload RCRA level Multi-truckload RCRA

UTILITIES AND ROADWAY

None Involves minor work on SCL, SPU or SDOT infrastructure or operations Involves major work on SCL, SPU or SDOT infrastructure or operations

GENERAL PUBLIC

None Incidental exposure of general public to worksite activities; if roadwork, limited to city property with no authorized public access

Moderate exposure of general public to worksite activities; if roadwork, limited to residential streets

Large numbers of general public exposed to worksite activities; if roadwork, involves arterials

BUILDERS RISK None

EARTH COLLAPSE

None Mechanical excavation or shoring up to one level Mechanical excavation or shoring over one level

GARAGE RISK

No Vehicle Bailment Parking Lot Vehicle Modification/Storage Tow Truck/On-Hook

VULNERABLE POPULATIONS

Minors, at-risk population, elderly, etc.

No contact Limited contact w/ vulnerable population, not primary operations

Moderate contact: Programs or operations w/ vulnerable population, w/ background checks, safety protocols in place

Primary operations involve vulnerable populations (1-on-1 unsupervised) mailto:(Bruce.Hori@seattle.gov mailto:Courtney.Beauchene@seattle.gov https://seattlegov-my.sharepoint.com/personal/samantha_anderson_seattle_gov/Documents/Desktop/checklists_transmittals/Samantha.Anderson@seattle.gov https://www.epa.gov/laws-regulations/summary-resource-conservation-and-recovery-act https://www.epa.gov/laws-regulations/summary-resource-conservation-and-recovery-act

Instructions:

Send ONLY Checklists with one or more HIGH* Risk Element boxes checked to Risk Management for review and sign-off. When sign-off received, transfer any additional coverages and/or limits requirements to the Insurance Transmittal Form and attach to Public Works agreement.

*With one exception: any Marine operations with MEDIUM or MEDIUM HIGH boxes checked should be sent to Risk Management.

If all boxes checked LOW, check “No Insurance Documentation Submittal Required” box on next page and in Consultant Contract. (Standard insurance is required, but no documentation is required to be submitted).

If one or more boxes checked MEDIUM, MEDIUM HIGH, but no HIGH and no items below are triggered, check “STANDARD Insurance”.

[*Excluding Watercraft & Maritime, see above]

If one or more boxes checked MEDIUM HIGH, but no HIGH, review below and add additional insurance as instructed to insurance requirements found on third page.

[*Excluding Watercraft & Maritime, see above]

If any trigger below is met, check box on next page: “NON-STANDARD” AND:

If “CONTRACT VALUE” Risk Element box checked MEDIUM HIGH, check “Umbrella or Excess Liability” box on next page with minimum limits $1,000,000 umbrella/excess and $1,000,000 general liability for minimum combined $2,000,000 overall liability including auto liability. If checked HIGH, send to Risk Management for insurance assessment.

If “MOTOR VEHICLES” Risk Element box checked MEDIUM HIGH, check “Umbrella or Excess Liability” box on next page with minimum limits $1,000,000 umbrella/excess and $1,000,000 general liability for minimum combined $2,000,000 overall liability including auto liability. If checked HIGH, send to Risk Management for insurance assessment.

If “AIRCRAFT” Risk Element box checked MEDIUM HIGH, check “Aviation Liability” box on next page with minimum $1,000,000 limit. If checked HIGH, send to Risk Management for insurance assessment. Note: Pilot [airplane, helicopter, drone] must also submit copy of pilot’s license.

If “WATERCRAFT” Risk Element box checked MEDIUM, MEDIUM HIGH, or HIGH, check “Watercraft/P&I Liability” box and send to Risk Management for insurance assessment.

If “MARITIME WC” Risk Element box checked MEDIUM HIGH or HIGH, check “Federal Maritime” and then “U.S. L.&H.” boxes under “Federal Maritime” on next page and send to Risk Management for insurance assessment.

If “ENVIRONMENTAL” Risk Element box checked MEDIUM or MEDIUM HIGH, check “Contractor’s Pollution Liability” insurance with minimum $1,000,000 limit and check “Automobile Liability” for “MCS-90 and CA 99 48” endorsements. If checked HIGH, send to Risk Management for insurance assessment. Note:

If contractor is only transporting pollutants and not responsible for remediating pollutants then check “MCS-90 and CA 99 48 endorsements” box.

If “PROFESSIONAL SERVICES” Risk Element box checked MEDIUM HIGH, check “Professional Liability (E&O)” box with $1,000,000 limit. Check “Technology E&O Insurance” box for software development with $1,000,000 limit. If checked HIGH, send to Risk Management for insurance assessment.

If “UTILITIES AND ROADWAY” Risk Element box checked MEDIUM HIGH or HIGH, check “Umbrella or Excess Liability” box on next page with minimum limits $1,000,000 umbrella/excess and $1,000,000 general liability for minimum combined $2,000,000 overall liability including auto liability.

If “GARAGE RISK” Risk Element box checked MEDIUM HIGH or HIGH, check “Garagekeepers” box on next page with $1,000,000 limit.

If “GENERAL PUBLIC” Risk Element box checked MEDIUM HIGH or HIGH, check “Umbrella or Excess Liability” box on next page with minimum limits $1,000,000 umbrella/excess and $1,000,000 general liability for minimum combined $2,000,000 overall liability including auto liability.

If “EARTH COLLAPSE” Risk Element box checked MEDIUM HIGH or HIGH check “XCU and SUBSIDENCE” box under Commercial General Liability on next page and send to Risk Management for insurance assessment.

If “VULNERABLE POPULATION” Risk Element box checked MEDIUM HIGH, check “Sexual Abuse/Molestation” insurance with minimum $1,000,000 limit. If checked HIGH, send to Risk Management for insurance assessment. Note: HIGH includes vendors with one-on-one operations with children.

https://seattlegov.sharepoint.com/sites/FAS_Purchasing_Contracting/Shared%20Documents/fas-city-finance-risk-transmittal-consultant-services.docx?web=1&csf=1&e=6c64f9dc9cc04f328f62da5769c776de

INSURANCE CERTIFICATION REQUIRED (STANDARD INSURANCE in Blue)

Standard Insurance Required, however no insurance documentation must be submitted: Check appropriate box in insurance paragraph of Consultant Contract STANDARD Insurance: Attach Insurance Transmittal form to Public Works agreement

NON-STANDARD ADDITIONAL COVERAGES OR INCREASED LIMITS: Attach Insurance Transmittal form to Consultant Contract with additional coverages and/or limits as per instructions or as may be specified by Risk Management.

REQUIRED COVERAGES AND MINIMUM LIMITS (STANDARD INSURANCE in blue; ADDITIONAL COVERAGES AND/OR INCREASED LIMITS OF LIABILITY in red.)

A. STANDARD INSURANCE REQUIRED:

Commercial General Liability (CGL) or equivalent insurance including coverage for:

Premises/Operations, Products/Completed Operations, Personal/Advertising Injury, Contractual, and Stop Gap/Employers Liability (coverage may be provided under a separate policy). Minimum limit of liability shall be $1,000,000 each occurrence Combined Single Limit bodily injury and property damage (“CSL”) except:

— $ 1,000,000 each offense Personal/Advertising Injury

— $ 1,000,000 each accident/disease Stop Gap/Employers Liability

— $ 2,000,000 Liquor Liability required if sale of liquor (for consumption) is involved. Otherwise, Liquor Liability not required XCU and SUBSIDENCE perils not excluded

Automobile Liability insurance for owned, non-owned, leased or hired vehicles, as applicable. The minimum limit shall be $1,000,000 CSL MCS-90 and CA 99 48 endorsements required unless In-transit Pollution coverage is covered under required Contractor’s Pollution Liability insurance Worker's Compensation insurance for Washington State as required by Title 51 RCW Industrial Insurance

B. ADDITIONAL COVERAGES AND/OR INCREASED LIMITS:

Umbrella or Excess Liability “follow form” insurance over primary CGL and Automobile Liability insurance limits, if necessary, to provide total minimum limits of liability of $2,000,000 or $ CSL. These required total minimum limits of liability may be satisfied with primary limits or any combination of primary and umbrella/excess limits

Contractor’s Pollution Liability insurance with minimum limits of liability of $1,000,000 or $ CSL each claim Aviation Liability insurance with minimum limits of $1,000,000 or $ CSL each occurrence Watercraft/P&I Liability insurance with minimum limits of $1,000,000 or $ CSL each occurrence Federal Maritime insurance with:

U.S.L.&H. minimum limits $1,000,000 or $ Jones Act minimum limits $1,000,000 or $

Professional Liability (E&O/Technical E&O) insurance appropriate to the consultant’s profession. The minimum limit shall be $1,000,000 or $2,000,000 each claim

Garagekeepers insurance with minimum limits $1,000,000 or $ per occurrence Sexual Abuse/Molestation with minimum limits $1,000,000 each occurrence, $2,000,000 aggregate or $ each occurrence.

Builder’s Risk with minimum limits $1,000,000 each occurrence, $2,000,000 aggregate or $ each occurrence.

Other: (to be provided by Risk Management)

REQUIRED FIELD

Name of individual completing this form: Date:

Risk Management Sign-off: Date:

[RM Signature NOT REQUIRED FOR STANDARD INSURANCE ONLY]

CONTINUATION OF SUMMARY OF SCOPE OF WORK MAY CONTINUE TO PAGE 4:

INSURANCE CERTIFICATION REQUIRED (STANDARD INSURANCE in Blue)