Insurance Agreement.doc

Purchasing Office

201 Sunrise Highway

Patchogue, New York 11772

Voice: (631) 687-3160

Fax: (631) 289-2327

E-mail: lconley@esboces.org

Insurance Certification Bid 25-48-0424: Ceiling Track Lift Systems To be considered for the award of this bid, both the Insurance Acknowledgement below and Vendor Acknowledgement on the following pages must be completed and signed.

Insurance Representative’s Acknowledgment:

We have reviewed the insurance requirements set forth in the bid and are capable of providing such insurance to our insured in accordance with such requirements in the event the contract is awarded to our insured and provided our insured pays the appropriate premium.

Summary of Insurance Requirements (Initial each):

· General Liability: $1mil/$2mil per project

· Endorsements

· Auto: $1mil

· Excess: $5mil/$5mil follow form

· Workers Compensation Certificate

· NYS Disability policy certificate

· ACORD 855 2014/05

Insurance Co or Broker Name:

Contact Phone Number:

The below signee must be an authorized representative for the above listed company.

Insurance Representative Name:

Print Name

Date:_______________________ _______________________________________________

Insurance Representative Signature

Purchasing Office

201 Sunrise Highway

Patchogue, New York 11772

Voice: (631) 687-3160

Fax: (631) 289-2327

E-mail: purchasing@esboces.org Insurance Agreement

Bid #25-48-0424: Ceiling Track Lift Systems 1.

The vendor hereby agrees to effectuate the naming of Eastern Suffolk BOCES as an additional insured on the vendor’s insurance policies, with the exception of workers' compensation and NY State Disability.

2.

The vendor’s policies will:

· Be an insurance policy from an A.M. Best rated "secured" or better insurer, authorized to conduct business in New York State. A New York licensed insurer is preferred. Insurers otherwise authorized to conduct business in New York may be accepted at BOCES’ discretion.

· State that the insured’s coverage will be primary and non-contributory coverage for ESBOCES, its Board, employees and volunteers;

· Name ESBOCES as an additional insured by providing standard or other endorsements that extend coverage to ESBOCES for both on-going and completed operations. The certificate must state that this endorsement is being used. A completed copy of the endorsement (s) must be attached to the certificate of insurance.

· The certificate of insurance must describe the specific services provided by the contractor (e.g., roofing, carpentry, plumbing) that are covered by the liability policies.

· A fully completed New York Construction Certificate of Liability Insurance Addendum (ACORD 855 2014/05) must be included with the certificates of insurance.

3.

The vendor agrees to indemnify ESBOCES for any applicable deductibles and self-insured retentions.

4.

Required Insurance:

· Commercial General Liability Insurance

$1,000,000 per occurrence/$2,000,000 aggregate

$2,000,000 Products and Completed Operations $1,000,000 Personal and Advertising Injury

$100,000 Fire Damage

$10,000 Medical Expense

The general aggregate shall apply on a per-project basis.

· Automobile Liability

$1,000,000 combined single limit for owned, hired and borrowed and non-owned motor vehicles.

· Excess Liability $5,000,000 per occurrence and aggregate. Excess coverage shall be on a follow-form basis.

· Workers' Compensation and New York State Disability Statutory Workers' Compensation, Employers' Liability and New York State Disability Insurance for all employees. Proof of coverage must be on the approved specific form, as required by the New York State Workers’ Compensation Board. ACORD certificates are not acceptable.

5.

If subcontracting is permitted in the bid specifications, the vendor will ensure compliance of these requirements by all subcontractors employed by the vendor.

6.

The vendor agrees that ESBOCES will not be responsible for any loss or damage whatsoever to property of the vendor or subcontractor.

7.

The vendor acknowledges that failure to obtain such insurance on behalf of ESBOCES constitutes a material breach of contract and subjects it to liability for damages, indemnification and all other legal remedies available to ESBOCES. The vendor will provide ESBOCES with a certificate of insurance, evidencing the above requirements have been met prior to the commencement of work or use of facilities.

Vendor Acknowledgment:

I acknowledge that I have received the insurance requirements of this bid and have considered the costs, if any, of procuring the required insurance and will be able to supply the insurance required in accordance with the bid, if it is awarded. I understand that a certificate of insurance must be submitted with my bid; and if it is not, Eastern Suffolk BOCES may reject my bid and award to the next lowest bidder.

Signature:

Print Name:

Title:

Company:

Address:

Contact Phone:

Email Address:

Date:

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9/2020