Form Center

Liability Insurance Requirements

2. Certificate of Insurance
   Each participating vendor must provide the City of Modesto with an appropriate insurance certificate or a signed liability waiver.
   
   Venders must provide general liability insurance with a minimum limit of liability per occurrence of $1,000,000 for bodily injury and property damage. Vendors must list the following information on the Certificate of Insurance in the area titled "Description of Operations" and Endorsements: The City of Modesto, its Officers, Agents, Employee & Volunteers are named as additional insured per the attached endorsement. Project: Earth Day in the Park Festival.
   
   Vendors shall provide the City with separate endorsements evidencing proof of the City's additional insured status as to both the general liability and automobile liability insurance policies.
   If applicable, Automobile Liability insurance with a minimum limit of liability per occurrence of $1,000,000 for bodily injury and property damage. This insurance shall cover any automobile for bodily injury and property damage.
   If applicable, Proof of Worker's Compensation Insurance for vendors who will have employees working during the event.
   All endorsements referenced above must include the applicable policy number.
6. Liability Insurance Waiver*

   I agree to hold the City, its agents, officers, employees, and volunteers, harmless from and save defend and indemnify them against any and all claims, losses, liabilities and damages from every cause, including but not limited to injury to person or property or wrongful death, with the indemnity to include reasonable attorney fees, and all costs and expenses, arising directly or indirectly out of any act or omission, whether or not the act or omission arises from the sole negligence or other liability of its agents, officers, employees, or volunteers relating to this event.

   1. I agree
8. Vendor Name*
9. Contact Name*
11. Day Phone*
12. Date*
    Date
14. Endorsements or Waivers

    1. I understand that endorsements or waivers must be received by April 1, 2020.
Leave This Blank:


16. 1. Receive an email copy of this form.
17. Email address

    This field is not part of the form submission.

18. Submit | Go Back