Insurance Requirement Form Minimum Insurance Coverages – The selected consultant shall, at its own expense, obtain and maintain in effect at all times the following types of insurance against claims, damages and losses due to injuries to persons or damage to property or other losses that may arise in connection with the performance of work under this Contract, placed with insurers with a Best’s rating of A-X or better. Yes (√) ___ ___ Please certify by checking the boxes at left that required coverages will be provided within five (5) days of Alameda CTC’s notice to firm that it is the successful proposer. Workers' Compensation Insurance in the amount required by the applicable laws, and Employer’s Liability insurance with a limit of not less than $1,000,000 per employee and $1,000,000 per occurrence, and any and all other coverage of Proposers’s employees as may be required by applicable law. Such policy shall contain a Waiver of Subrogation endorsement in favor of Alameda CTC. Such Workers Compensation & Employers Liability may be waived, if, and only for as long as, the selected consultant is a sole proprietor with no employees. Commercial General Liability Insurance for Bodily Injury and Property Damage liability, covering the operations of the selected consultant and its officers, agents, and employees and with limits of liability which shall not be less than $1,000,000 combined single limit per occurrence with a general aggregate liability of not less than $2,000,000, and Personal & Advertising Injury liability with a limit of not less than $1,000,000. Expense for Indemnitee’s defense costs shall be outside of policy limits and such policy shall be issued on a Duty to Defend Primary Occurrence Form. Alameda CTC, FHWA (if applicable), MTC (if applicable), Caltrans and their respective commissioners, directors, officers, representatives, agents and employees are to be named as additional insureds. Such insurance as afforded by this endorsement shall be primary as respects any claims, losses or liability arising directly or indirectly from the selected consultant’s operations. ___ ___ ___ Business Automobile Insurance for all automobiles owned, used or maintained by Proposer and Proposer’s officers, agents and employees, including but not limited to owned, leased, nonowned and hired automobiles, with limits of liability which shall not be less than $1,000,000 combined single limit per occurrence. Umbrella Insurance in the amount of $1,000,000 providing excess limits over Employer’s Liability, Automobile Liability, and Commercial General Liability Insurance. Property Insurance covering the selected consultant’s own business personal property and equipment to be used in performance of this Contract, materials or property to be purchased and/or installed on behalf of Alameda CTC (if any), debris removal (if applicable), and builders risk for property in the course of construction (if applicable). Coverage shall be written on a "Special Form" ("All Risk") that includes theft, but excludes earthquake, with limits at least equal to the replacement cost of the property. Such policy shall contain a Waiver of Subrogation in favor of Alameda CTC. If such insurance coverage has a deductible, the selected consultant shall also be liable for the deductible. Deductibles: Any deductibles or self-insurance retentions over $50,000 are subject to the approval of Alameda CTC. Notice of Termination: All policies shall provide that the insurance carrier shall give written notice to Alameda CTC at least 30 days prior to cancellation, non-renewal or material change of coverage in the policy or policies, and shall provide notice of such change to Alameda CTC and any other additional insured. Additional Provisions: Each policy or policies of insurance described in Commercial General Liability Insurance, above shall include an endorsement providing that such insurance is primary insurance and no insurance of Alameda CTC will be called on to contribute to a loss.: Certificates of Insurance: Promptly on execution of this Contract and prior to commencement of any work hereunder, the consultant shall deliver to Alameda CTC Certificates of Insurance verifying the aforementioned coverages. Such certificates shall make reference to all provisions and endorsements referred to above and shall be signed on behalf of the insurer by an authorized representative thereof. Proposer agrees, upon written request by Alameda CTC, to furnish copies of such policies or endorsements required under the Contract prior to the Effective Date of the Contract. Disclaimer: The foregoing requirements as to the types of limits of insurance coverage to be maintained by consultant are not intended to and shall not in any manner limit or qualify the liabilities and obligations otherwise assumed by consultant pursuant hereto, including, but not limited to, liability assumed pursuant to indemnification. Subconsultant’s Insurance: The Consultant shall require each of its subconsultants to provide the aforementioned coverages, unless such coverages are waived or reduced in writing by the Alameda CTC Project Manager and Contracting, Administration, and Fiscal Resource Manager. By signing below, you acknowledge and agree to provide the required certificate of insurance providing verification of the minimum insurance requirements listed above within five (5) days of Alameda CTC’s notice to firm that it is the successful proposer. Authorized Signature Name and Title Date NOTE: If you were unable to check “Yes” for any of the required minimum insurance coverages listed above, a request for exception to the appropriate insurance requirement(s) must be brought to Alameda CTC’s attention no later than the date for protesting RFP provisions. If such objections are not brought to Alameda CTC’s attention consistent with the protest provisions of this RFP, compliance with the insurance requirements will be assumed.
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