Right to Modify. Notwithstanding any provisions in the Contract to the contrary, the City, City’s Department of Finance, Risk Management Office maintains the right to modify, delete, alter or change these requirements. INSURANCE CERTIFICATE OF COVERAGE Named Insured: Specification #: Address: RFP: Project#: (City) (State) (Zip) Contract#: Description of Operation/Location The insurance policies and endorsements indicated below have been issued to the designated named insured with the policy limits as set forth herein covering the operation described within the contract involving the named insured and the City of Chicago. The Certificate issuer agrees that in the event of cancellation, non-renewal or material change involving the indicated policies, the issuer will provide at least sixty (60) days prior written notice of such change to the City of Chicago at the address shown on this Certificate. This certificate is issued to the City of Chicago in consideration of the contract entered into with the named insured, and it is mutually understood that the City of Chicago relies on this certificate as a basis for continuing such agreement with the named insured: Type of Insurance Insurer Name Policy Expiration Limits of Liability Number Date All Limits in Thousands General Liability CSL Per [ ] Claims made [ ] Occurrence Occurrence $ _________ [ ] Premise-Operations [ ] Explosion/Collapse General Underground Aggregate $ _________ [ ] Products/Completed-Operations [ ] Blanket Contractual Products/Completed [ ] Broad Form Property Damage Operations [ ] Independent Contractors Aggregate $_________ [ ] Personal Injury [ ] Pollution Automobile Liability CSL Per Occurrence $ _________ [ ] Excess Liability Each [ ] Umbrella Liability Occurrence $ _________ Compensation and Statutory/Illinois Worker’s Liability Employers Employer’s Liability $ _________ Builders Risk/Course of Amount of Contract Construction Professional Liability $ _________
City’s Right to Modify. Notwithstanding any provisions in the Contract to the contrary, the City, Department of Finance, Risk Management Office maintains the right to modify, delete, alter or change these requirements. INSURANCE CERTIFICATE OF COVERAGE Named Insured: Specification #: Address: RFP: Project#: (City) (State) (Zip) Contract#: Description of Operation/Location The insurance policies and endorsements indicated below have been issued to the designated named insured with the policy limits as set forth herein covering the operation described within the contract involving the named insured and the City of Chicago. The Certificate issuer agrees that in the event of cancellation, non-renewal or material change involving the indicated policies, the issuer will provide at least sixty (60) days prior written notice of such change to the City of Chicago at the address shown on this Certificate. This certificate is issued to the City of Chicago in consideration of the contract entered into with the named insured, and it is mutually understood that the City of Chicago relies on this certificate as a basis for continuing such agreement with the named insured: Type of Insurance Insurer Name Policy Number Expiration Date Limits of Liability All Limits in Thousands General Liability [ ] Claims made [ ] Occurrence [ ] Premise-Operations [ ] Explosion/Collapse Underground [ ] Products/Completed-Operations [ ] Blanket Contractual [ ] Broad Form Property Damage [ ] Independent Contractors [ ] Personal Injury [ ] Pollution CSL Per Occurrence $ _________ General Aggregate $ _________ Products/Completed Operations Aggregate $_________ Automobile Liability CSL Per Occurrence $ _________ [ ] Excess Liability [ ] Umbrella Liability Each Occurrence $ _________ Worker’s Compensation and Employer’s Liability Statutory/Illinois Employers Liability $ _________ Builders Risk/Course of Construction Amount of Contract Professional Liability $ _________
Vol-II_PSTA_DB_Agreement_Template_20180408.docx