HomeMy WebLinkAboutInsurance Approval Form 2DEPARTMENT OF RISK MANAGEMENT
INSURANCE/SAFETY APPROVAL FORM
Name
Julia Martin
Department
Fire
Review
Status
Commercial General Liability
Auto Liability:
Workers Comp:
Liquor Liability:
Builder Risk:
Professional Liability:
Garage Keepers Liability:
Excess Liability:
Crime Coverage
Pollution:
Description ' Disaster Relief Funding Agreements for Federal and\
State Assistance for Hurricane Rita and Wilma
Tracking #
Date:
12/1 /2005
Financial
Ratings Strength REQUIREMENTS:
xx
Insurance NOT Required
City of Miami is Named Additional Insured
The City is providing insurance
City of Miami is Loss Payee
Bayfront Park Named Additional Insured
APPROVAL STAL'US
xx APPROVE
Frank Gomez
Insurance Coordinator
Patrice Rey
Safety/ADA Coordinator
i
Not Approved
Coverage is insufficient
Not A Rated Company
A Type of Coverage is Missing
Other
The City NOT Named Additional Insured
Insurance/Safety Comments:
Indemnification in accordance and subject to FS 768.28.
Risk 002 . 12/1/2005 .... 4:45 PM