RFP 27-017AG Ack of Insurance Requirement.pdf

12/2025

RFP No. 27-017AG Section V. “Proposal Content and Forms”

CITY OF CORONA ELECTRIC UTILITY BATTERY ENERGY STORAGE SYSTEM FEASIBILITY STUDY

ACKNOWLEDGMENT OF THE INSURANCE REQUIREMENTS CHECK SHEET

(To be Completed and Submitted with Consultant’s Proposal)

All applicable insurance requirements to this RFP are identified with a ‘YES’ under the “Applicable to Vendor” column on the RFP Insurance Requirements Check List.

Consultant acknowledges that we have reviewed the City of Corona Insurance Requirements Check Sheet and understand that we will be able to provide the insurance coverage required. A sample certificate of insurance is enclosed for the City’s preliminary review.

(Firm Name)

(Print name and title of person signing for firm)

(Signature/Date)

CITY OF CORONA ELECTRIC UTILITY BATTERY ENERGY STORAGE SYSTEM FEASIBILITY STUDY

City of Corona RFP No. 27-017AG Insurance Requirements Check List

(To be Completed and Submitted with Consultant’s Proposal)

All applicable insurance requirements are identified with a ‘YES’ under the “Applicable to Vendor” column. Indicate Yes or No below if you are able to comply with the requirement.

YES NO

Applicable to

Vendor Can your company provide General Liability - $1M occurrence/$2M aggregate? YES Can your company provide Automobile Liability - $1M? YES Can your company provide Workers Compensation and Employer's Liability - $1M? YES Can your company provide Errors and Omissions (Professional) Liability Insurance - $1M per claim or occurrence/$2M aggregate? YES Can your company provide Technology Professional Errors and Omissions Liability Insurance - $2M occurrence or $2M aggregate? Not

Applicable Can your company provide Builders'/All Risk for the completed value of the project naming the City as the loss payee? Not

Applicable Can your company provide Contractor’s Pollution Liability and Transportation Pollution Liability with minimum limits of $1 million/$2 million with a primary Additional Insured endorsement?

Not Applicable

Can your company provide coverage with an insurer with a current A.M. Best’s rating no less than (A-):VII and licensed as an admitted insurance carrier in California? YES Can your company provide coverage with an insurer with a current A.M. Best’s rating no less than (A-):X and authorized to issue the required policies in California? YES Will your insurance policies have a (30) days' notice of cancellation endorsement? YES If your firm is unable to provide a (30) day notice of cancellation will your firm sign a City provided statement that the Vendor shall notify the City within two business days any notice of cancellation? YES Does your insurance have any deductibles and/or self-insurance retentions? YES

Insurance Endorsements

General Liability

YES NO

Applicable to

Vendor (Occurrence form CG 0001) YES Will your company provide an insurance policy that states the City, its directors, officials, officers, employees, agents, and volunteers shall be covered as additional insured with respect to liability arising out of work or operations performed by or on behalf of the Consultant, including materials, parts or equipment furnished in connection therewith?

YES

Will your company provide an insurance policy that states any person or organization whom you have agreed to include as an additional insured under a written contract?

provided such contract was executed prior to the date of loss?

Can your company provide Completed Operations as evidenced with the following endorsements? YES Endorsement form CG 20 10 11 85 OR YES CG 20 37 and one of the following YES

CG 20 10 YES

CG 20 26

CITY OF CORONA ELECTRIC UTILITY BATTERY ENERGY STORAGE SYSTEM FEASIBILITY STUDY

CG 20 33

CG 20 38

Will your company provide a General Liability endorsement stating that the insurance coverage shall be primary any City insurance will be in excess of the consultant’s insurance and will not be called upon to contribute Endorsement Form shall be as broad as CG 20 01 04 13? YES

Automobile Liability

YES NO

Applicable to

Vendor Does your insurance cover Owned automobiles with Form number CA 0001 code 1 (Any Auto)? YES If your company does not have owned automobiles, does your insurance cover No owned autos Code 8 (hired) and 9 (non-owned)? YES

Workers' Compensation

YES NO

Applicable to

Vendor Will your company provide a waiver for all rights of subrogation against the City, its directors, officials, officers, employees, agents, and volunteers for losses paid under the terms of the insurance policy which arise from work or Services performed by the Consultant?

Will your company provide a Waiver of Subrogation – All Other Policies. Consultant hereby waives all rights of subrogation any insurer of Consultant’s may acquire against the City, its directors, officials, officers, employees, agents, and volunteers for losses paid under the terms of any insurance policy which arise from work or Services performed by the Consultant?

Use the space below to explain any "NO" responses.