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CERTIFICATE OF INSURANCE <br />REQUIREMENTS <br />Your certificate must carry a minimum of the following ].imitations: <br />General Liabilit <br />Public Liability insurance shall not be less than $300,000 for <br />injuries; including accidental death to any one person, and <br />subject to the same limit for each person, in any amount of not <br />less than $300,000. On account of any one accident and property <br />damage insurance in the amount of not less than $100,000 for each <br />accident and not less that $100,000 aggregate. <br />(example) <br />Each occurrence A aregate <br />Bodily Injury $300,000 $300,000 <br />Property Damage $100,000 $100,000 <br />** Cr if a combined policy is used the minimum must be <br />$300,000/Each Occurrence and Aggregate. <br />Korkers Compensation <br />The State requires that if a sole propietor or partnership, the <br />City of Roseville must have you complete the information below <br />if you choose not to carry Worker's compensation on yourself. <br />This must be signed by all parties involved if it is a <br />partnership. <br />_ _----------------------- <br />-- (detach here and return lower portion) <br />Company Name <br />As a Sole Proprietor or Partnership, I/We have c1losen not ro carry <br />Worker's Compensation on myself/ourselves. <br />Signature <br />Signature <br />