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City of Casselberry I Procurement and Contract Management Division <br />95 Triplet Lake Drive, Casselberry, Florida 32707 <br />Phone: 407-262-7700, Ext. 1142 1 procurementCD-casselberry. org <br />RFP -2020-0579 BUILDING OFFICIAL SERVICES <br />Worker's Compensation 1 $1,000,000.00 <br />WORKERS' COMPENSATION: Employers' liability insurance which covers the statutory obligation <br />for all persons engaged in the performance of the work required hereunder with limits not less than <br />$1,000,000.00 per occurrence. Evidence of qualified self-insurance status will suffice for this <br />subsection. The CONTRACTOR understands and acknowledges that it shall be solely responsible <br />for any and all medical and liability costs associated with an injury to itself and/or to its employees, <br />sub -contractors, volunteers, and the like, including the costs to defend the CITY in the event of <br />litigation against same. <br />B. The CONTRACTOR shall name the "City of Casselberry" as a certificate holder and/or as additional <br />insured, to the extent of the services to be provided hereunder, on all required insurance policies, <br />and provide the CITY with proof of same. <br />C. The CONTRACTOR shall provide the CITY's Human Resources/Risk Management Division with a <br />Certificate of Insurance evidencing such coverage for the duration of this Agreement. Said Certificate <br />of Insurance shall be dated and show: <br />1. The name of the insured CONTRACTOR; <br />2. The specified job by name and job number; <br />3. The name of the insurer; <br />4. The number of the policy; <br />5. The effective date; <br />6. The termination date; and, <br />7. A statement that the insurer will mail notice to the CITY at least thirty (30) days prior to any <br />material changes in the provisions or cancellations of the policy. <br />8. The Certificate Holders Box must read as follows: <br />City of Casselberry <br />c/o Administrative Services Director <br />95 Triplet Lake Drive <br />Casselberry, Florida 32707 <br />Any other wording in the Certificate Holders Box shall not be acceptable. Non -conforming certificates will <br />be returned for correction. <br />D. Receipt of certificates or other documentation of insurance or policies or copies of policies by the <br />CITY, or by its representatives, which indicates less coverage than is required, does not constitute a <br />waiver of the CONTRACTOR's obligation to fulfill the insurance requirements specified herein. <br />E. The CONTRACTOR shall ensure that any sub-contractor(s), hired to perform any of the duties <br />contained in the Scope of Services of this Agreement, maintain the same insurance requirements set <br />forth herein. In addition, the CONTRACTOR shall maintain proof of same on file and made readily <br />available upon request by the CITY. <br />SECTION 15 CITY OBLIGATIONS <br />At the CONTRACTOR's request, the CITY agrees to provide, at no cost, pertinent information known and readily <br />available to the CITY to assist the CONTRACTOR in providing and performing the required services. <br />PUR-F-405 5 10/2019 <br />