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02/04/20OU 08-'14 FAX 612 789 1543 CITY OF MPLS-FIRE TOWER Q 0 12 u u hir. i v irv%ju r(Aiv%.*r-%0uvrr%A%jr. in %,a i ir tov i irw nsurance Certificates "yen though contracts stale that insurance coverage is required, it is important to vefify the Insurance through the ,eflificate, The department contract manager must obtain can es or w rs for 0 instiranc4 Oed in the contract at he VM9 of oontract Onset and throughout the contract pedod. The department contract manager and the Contract Aa nag ement Office in Purchasing must retain copies of these certificates or waivers. attached iS a copy ofthe preferred City insurance certificate with the important area highIg lit ed. Please send It to your . ontractorif needed. Upon rece-Ning the insurance certhicate from your contractor, you must check A to make sure k is 3=ptable. The cacti Gate standards are as follows: Check the form itseff * Must be Aoord or UY insurance form, except an Assigned Risk'grogram cerfificate from the State of Minnesota �s a acceptable for;' o fs Compensation. In addhion, :a Risk ManaoeMentwappMved letter from governmental body disclosing their Self-insured status is also acceptable. 0 A representat" "m th a "Insurance company must sign the form. A copy of the fo" is accep0ble. 9 if there Is a slut for addftlonal 'Insured for the General Liability and Auto Liabidfty sections,, this must be checked. If there Ls a space for the add Rional Insured, this must be the City of Minneaports. # The oontractor name on the oedtflWe must match the contractor name on the writracL 9 If there is a box rAddvtional Insured, this should be checked. If checked and the Addhicanal Insured name is provided, this should be the City of MinneapoUs. The form is ameptable if no such box is on the forrn. For Worker's Cornponsation, the City would typica4 not be listed asAddhional Insured. Check the Coverage 0 The dates of wyang e for 0 requilmd insurance must at least cover the contmut starting date up through the ourmrt date it back*dated) or the contract stain g data (if future-dated) 0 Read any speCtal notes added to the certiflcate to determine if problematic or if they 11m ft the scope of the Insurance, % AJI coverage levels shiould meet or exceed those mquired by the contract, with the following exceptions., General Liability A blank General Aggregate is acceptable 9 Each Occurrence is filled in with an amount that meet$ or exceeds the requilroment. % A blank Each occurrence is acceptable if General Aggregate is filled in wfth an amount that meets or a s the requirement. 10 If Products,*Completed Operati= Aggregate, Personal and Advertising Injury or Fire Damage is blanK or Wow the requirement. Risk Manageffient will need to send an E-mail to approve the vadation from the Mqu"rernent. Untact Risk Management if this occurs. 0 If Medical is blank or below the requirement, Ns is acceptable. 9 Business Viers :LiaWy can substlute for Commardal General Liability If the General Aggregate level nmtetS the requirement. Auto 4 Bod4 injury Each Person or Bodily Injury per accident with coverage as per reqwreftnt is acceptable, Workars Compensation 16 If the State of Minnesota Assigned:Rlsk form i4s 1*ng used, "no coverage for Part B* Is acceptable, Prepared by Let Lama ift C*Ajum4ion with Risk P4anag*pftrA rev izcd 60M