Attachment D. Insurance



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Insurance Contractor/Vendor: The City and County of San Francisco would like to direct your attention to the City's insurance requirements, which have proved confusing to some bidders in the past. We have enclosed a sample of the Certificate of Insurance and Additional Insured Endorsements. These are standard insurance industry forms, and your broker should be aware of them. The successful bidder must submit the Certificate of Insurance and Additional Insured Endorsements with the required insurance coverages prior to receiving an order/contract agreement. Please review these forms and the insurance portion of the bid document with your insurance broker for assurance that the mandatory types and limits of insurance coverages are available or already in place. If you are the successful bidder, you must provide evidence of insurance within an allotted time. If you fail to provide the Certificate of Insurance and Additional Insured Endorsements, your bid may be disqualified. Please note that the attached Certificate reflects the standard types and limits of insurance the City requires most often, the requirements of each proposal may differ, in which case the proposal's specific requirements shall prevail. Please be certain you and your insurance broker review the insurance requirements of the proposal carefully. If you and/or your broker have any questions concerning our insurance requirements, please call the contact person in charge of this bid/rfp. NOTE: Additional Insured Endorsement must be issued by the insurance carrier. P-607 (1-07)

PRODUCER: INSURED: CERTIFICATE OF INSURANCE ISSUE DATE: THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER OTHER COVERAGE AFFORDED BY THE POLICIES BELOW. LETTER A LETTER B LETTER C COMPANIES AFFORDING COVERAGE LETTER D COVERAGES AND LIMITS THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO. LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF. DATE POLICY EXP. DATE DESCRIPTION GENERAL LIABILITY GENERAL AGGREGATE $2 million X COMM. GENERAL LIAB. PROD-COMP/OP AGG. $1 million CLAIMS MADE PERS & ADV. INJURY $1 million X OCCURRENCE EACH OCCURRENCE $1 million LIMITS OWNER S & CONTRACT S PROT FIRE DAMAGE (One Fire) MEDICAL EXPENSE (One Per) AUTOMOBILE LIABILITY X ANY AUTO COMBINED SINGLE LIMIT $1 million ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per Person) BODILY INJURY (Per Accident) X HIRED AUTOS PROPERTY DAMAGE X NON-OWNED AUTOS GARAGE LIABILITY EXCESS LIABILITY UMBRELLA FORM EACH OCCURRENCE AGGREGATE OTHER THAN UMBRELLA FORM WORKERS COMPENSATION X STATUTORY LIMITS AND EACH ACCIDENT $1 million EMPLOYER S LIABILITY DISEASE - POLICY LIMIT $1 million OTHER INSURANCE DISEASE - EACH EMPLOYEE $1 million DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS: (1) Additional Insureds: City and County of San Francisco, its officers, employees and agents. (Endorsement required) (2) Liability insurance is primary and applies separately to each insured, except with respect to limits of liability. (Endorsement required) (3) Endorsement must be attached with the Certificate. NAME AND ADDRESS OF CERTIFICATE HOLDER: City and County of San Francisco Department Name Attn: Address City, State, Zip Code CANCELLATION: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE, ITS AGENTS OR REPRESENTATIVES. (See contract requirements for any changes to this Section.) AUTHORIZED REPRESENTATIVE: (Signature required) P-607 (1-07)

P-607 (1-07)

INSURANCE SCENARIOS Scenario 1 City orders goods that are shipped to City by vendor via 3 rd party shipper (UPS, FedEx, etc.) B. Commercial General Liability policy shall be endorsed to provide the following (on a separate endorsement document with applicable policy number(s) listed): Scenario 2 City orders goods that are shipped by vendor via the vendor s own vehicles (delivery trucks, etc.) with vendor employees that will come on to City property for delivery only. B. Commercial Automobile Liability Insurance with limits not less than $1,000,000 each occurrence Combined Single Limit Bodily Injury and Property Damage, including Owned and Non-Owned and Hired Auto Coverages, as applicable. C. Commercial General Liability and Comprehensive Automobile Liability Insurance policies shall be endorsed to provide the following (on a separate endorsement document with applicable policy number(s) listed): D. Workers Compensation, with Employers Liability limits not less than $1,000,000 each

Scenario 3 City orders goods or services that require vendor vehicles and employees to come on to City property for the purpose of performing work for the City while on City property. B. Commercial Automobile Liability Insurance with limits not less than $1,000,000 each occurrence Combined Single Limit Bodily Injury and Property Damage, including Owned and Non-Owned and Hired Auto Coverages, as applicable. C. Commercial General Liability and Comprehensive Automobile Liability Insurance policies shall be endorsed to provide the following (on a separate endorsement document with applicable policy number(s) listed): D. Workers Compensation, with Employers Liability limits not less than $1,000,000 each E. Waiver of Subrogation for Workers Compensation insurance coverage. Scenario 4 City orders goods or services where the City delivers City property (vehicles or equipment) to vendors to be worked on at the vendor s facilities. Insurance Needed B. Commercial General Liability policy shall be endorsed to provide the following (on a separate endorsement document with applicable policy number(s) listed):

C. Workers Compensation, with Employers Liability limits not less than $1,000,000 each D. Garagekeepers Liability Insurance or Property of Others Insurance or Bailee s/custody and Care Insurance coverage. Scenario 5 City orders goods or services where the vendor comes onto City property to pick up City property (vehicles or equipment) to deliver to vendor s location to be worked on at the vendor s facilities. B. Commercial Automobile Liability Insurance with limits not less than $1,000,000 each occurrence Combined Single Limit Bodily Injury and Property Damage, including Owned and Non-Owned and Hired Auto Coverages, as applicable. C. Commercial General Liability and Comprehensive Automobile Liability Insurance policies shall be endorsed to provide the following (on a separate endorsement document with applicable policy number(s) listed): D. Workers Compensation, with Employers Liability limits not less than $1,000,000 each E. Garagekeepers Liability Insurance (for vehicles) or Property of Others Insurance or Bailee s/custody and Care Insurance coverage.