Insurance_Checklist_2023.pdf
PDF 174 KB Posted
- Solicitation number
- 26-078-RFP
- Issued by
- Yolo County, California
About this file
This is an Insurance Checklist document issued by the City of West Sacramento establishing certificate of insurance requirements for standard city contracts. The document outlines mandatory insurance coverage that all contractors and vendors must obtain and provide to the City prior to contract execution. The required coverage includes Commercial General Liability of $1,000,000 per occurrence/$2,000,000 aggregate, Commercial Automobile Liability of $1,000,000 per accident, Workers' Compensation and Employers' Liability per statutory requirements, and Professional Liability (Errors & Omissions) of $1,000,000 per claim if applicable. All policies except Workers' Compensation and Professional Liability must name the City of West Sacramento—specifically its officers, officials, employees, agents, and volunteers—as additional insureds. The City's mailing address for Certificate of Liability Insurance is listed as 1110 West Capitol Avenue, West Sacramento, CA 95691.
All certificates of insurance must include specific endorsements to verify policy compliance. For General Liability and Automobile Liability coverage, contractors must provide Additional Insured Endorsements equivalent to CG 2010 0714, Primary and Noncontributory Endorsements, and Separation of Insureds endorsements. Workers' Compensation policies must include either a Waiver of Subrogation Endorsement in favor of the City or a Workers Compensation Waiver for self-employed individuals without employees. All certificates must provide thirty days' written notice to the Certificate Holder prior to cancellation or material change of any insured coverage. Contractors are instructed to forward this checklist to their insurance agent or broker, and copies of all Additional Insured Endorsements must be attached to the Certificate of Insurance or the certificate will be deemed incomplete.
View the file
Other files
Show all 12
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
Vendor Name:
Date of Internal Review:
CERTIFICATE OF INSURANCE REQUIREMENTS FOR STANDARD CITY CONTRACTS
REQUIRED INSURANCE: Below are the insurance requirements on all Standard City Contracts.
CONTRACTORS/VENDORS: Please forward this list to your insurance agent/broker.
• All policies except Workers’ Compensation & Professional Liability shall name the City as an additional insured.
• A copy of the Additional Insured Endorsement must be attached to the Certificate verifying that the Insured’s policy(s) has been endorsed as required or certificate will be considered incomplete.
• All certificates shall provide for thirty (30) days’ written notice to Certificate Holder prior to cancellation or material change of any insurance referred to in the certificate.
Certificate of Liability Insurance (COI)
Certificate Holder: City of West Sacramento officers, officials, employees, agents, and volunteers (Please do not list any specific departments or individuals) City Address unless otherwise stated: 1110 West Capitol Avenue, West Sacramento, CA 95691
Required Insurance Coverage *City Contract Minimum*
☐ Commercial General Liability $1,000,000 Per Occurrence / $2,000,000 Aggregate*
☐ Commercial Automobile Liability $1,000,000 Per Accident*
☐ Workers’ Compensation and Employers’ Liability Per statutory requirements
☐ Professional Liability (Errors & Omissions) if applicable $1,000,000 Per Claim*
General Liability – Additional Insured Endorsements
☐ Additional Insured Endorsement equivalent to CG 2010 0714 naming the City, its officers, officials, employees, agents, and volunteers as additional insureds
☐ Primary and Non‐Contributory Endorsement stating insurance is primary and non‐contributory
☐ Separation of Insureds stating that the insurance shall apply separately to each insured
Automobile Liability – Additional Insured Endorsements
☐ Additional Insured Endorsement equivalent to CG 2010 0714 naming the City, its officers, officials, employees, agents, and volunteers as additional insureds
☐ Primary and Non‐Contributory Endorsement stating insurance is primary and non‐contributory
☐ Separation of Insureds stating that the insurance shall apply separately to each insured
Workers Compensation Endorsements
Waiver of Subrogation Endorsement (Waiver of Transfer of Rights of Recovery) on Worker’s Compensation policy in favor of the City, its officers, agents, and employees or Workers Comp Waiver if self‐employed with no employees
Internal Notes:
Approved:
| undefined: Off |
| undefined_2: Off |
| undefined_3: Off |
| undefined_4: Off |
| undefined_5: Off |
| undefined_6: Off |
| undefined_7: Off |
| undefined_8: Off |
| undefined_9: Off |
| undefined_10: Off |
| undefined_11: Off |
| undefined_12: Off |
| undefined_13: Off |
| Internal Notes: |
| Text1: |
| Text2: |
| Clear Form: |
| Text3: |
File details come from the government source that posted it. Updated .