Insurance Certificates 2020/21 Ocean Springs TechINSURANCE REVIEW
RE:
Please list the Contracting Party / Vendor Name, type of agreement to be executed, including any change orders or
amendments, and the type of services to be provided. Make sure to list any related Project No. and Project Name.
Insurance certificates required per the Agreement:
ACCORD Certificate dated 10-days prior or less _____________________________
enter ACCORD issue date
Commercial General Liability Insurance:
$1,000,000 per occurrence/$2,000,000 aggregate OR
$2,000,000 per occurrence/$4,000,000 aggregate
Additional Insured Endorsement naming City of La Quinta
Primary and Non-Contributory Endorsement
Automobile Liability:
$1,000,000 combined single limit for bodily injury and property damage.
Workers’ Compensation:
Statutory Limits / Employer’s Liability $1,000,000 per accident or disease
Workers’ Compensation Endorsement with Waiver of Subrogation
Sole Proprietor
Professional Liability (Errors and Omissions):
Errors and Omissions Liability insurance with a limit of not less than
$1,000,000 per claim
Cyber Liability/Technology Errors and Omissions Liability Insurance:
$1,000,000 per occurrence/loss
Other: ________________________________________________________
List other insurance types such as – molestation, harassment, etc.
Approved by: ________________________
Date: ________________________
Not Applicable
Not Applicable
07/14/2020