Contract Insurance Requirements
A completed and current City of Mesa Insurance form is required for each active Capital Improvement
Project contract. Construction Contract
The Accord form is not accepted. A completed construction
contract
Certificate of Insurance
(.pdf 1 page) must include:
-
City of Mesa form except Workers Compensation/Employers Liability if provided by
SCF of Arizona
-
Complete each box separately
-
Project Number in top right hand corner
-
Name of Insured
-
Name of Carrier, Policy Number, Policy Period, and
Actual Coverage amount is listed for each
required coverage
-
Policy Numbers must be actual policies, binders are
not allowed
-
Policy periods must have a beginning and ending
date
-
Course of Construction Coverage is only required
when a City owned building is under
construction/modification
-
Owners' Liability (.pdf 1 page) is required
through acceptance date of project
-
Forms must be signed and dated
|
Insurance Coverages: |
Liability
Minimums: |
|
Worker’s
Compensation
(1,000,000/500,000/100,000) |
Statutory |
| Employers
Liability (1st
number in Workers Comp) |
1,000,000 |
| Auto
Liability |
1,000,000 |
| General Liability |
1,000,000 |
Excess/Umbrella
Liability
(if
Employers Liability is not minimum) |
1,000,000 |
Course
of Construction
(if City owned building) |
1,000,000 |
| Owners
Liability |
2,000,000 |
Faxed copies are accepted with originals to follow via mail.
When all required information has been received, contracts can be executed and/or payments can be
processed. Professional
Services Contract The Accord form is accepted as renewal certificates. A completed
professional services contract
Certificate of Insurance
(.pdf 1 page) must include:
|
Insurance Coverages: |
Liability
Minimums: |
| Worker’s
Compensation
(1,000,000/500,000/100,000) |
Statutory
|
| Architects/Engineers
Professional Liability (each occurrence) |
1,000,000 |
| Commercial Automobile
Liability (CSL each occurrence) |
1,000,000 |
| Commercial General Liability
including Contractual (unimpaired, each occurrence) |
1,000,000 |
| Excess Liability |
See Form |
| Valuable Papers |
See Form |
Faxed copies are accepted with originals to follow via mail.
When all required information has been received, payments can be
processed. |
