Insurance.pdf

Bid #26-14-0624 Public Address System Services

Purchasing Office

201 Sunrise Highway Patchogue, New York 11772

Voice: (631) 687-3160 Fax: (631) 289-2327

E-mail: lconley@esboces.org

Attachment B

Insurance Certification

Bid #26-14-0624: Public Address System Services

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/occur/$2mil/aggregate $2mil Prod & Completed Ops $1mil Pers and Adv Injury $100,000 Fire Damage $10,000 Medical Expense Per project

• Endorsements _____

• Auto: $1mil _____

• Excess: $5mil/$5mil follow form _____

• Workers Compensation Certificate _____

• NYS Disability policy certificate _____

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 #26-14-0624: Public Address System Services

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 A- rated or better insurer, licensed to conduct business in New York State. A New York licensed and admitted insurer is strongly preferred. The decision to accept non-licensed and non-admitted carriers lies exclusively with ESBOCES and may create significant vulnerability and costs for ESBOCES.

State that the insured’s coverage will be primary and non-contributory coverage for ESBOCES, its Board, employees and volunteers with a waiver of subrogation in favor of ESBOCES for all coverages including Workers Compensation.

Additional Insured Status for ESBOCES and Participants of Cooperative

Bids:

• Cooperative bids ONLY – Additional Insured status shall only be secured by the Participant upon execution of a “Participant Insurance and Indemnification Agreement” signed by both the Vendor and Participant.

• Individual BOCES bids (excluding Cooperative Bids) do not require a “Participant Insurance and Indemnification Agreement” to secure additional insured status by the vendor.

Additional Insured Status shall be provided by standard or other endorsements that extend coverage to the Participant or ESBOCES for ongoing (CG 20 38) or equivalent and completed operations (CG 20 37) or equivalent. The decision to accept an endorsement rests solely with the Participant or ESBOCES. A completed copy of the endorsements must be attached to the Certificate of Insurance to include General Liability, Auto Liability and Umbrella/Excess coverages.

There will be no coverage restrictions and/or exclusions involving New York

State Labor Law statutes or gravity related injuries.

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

4. Required Insurance:

o 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.

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

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

o 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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