HomeMy WebLinkAboutInsurance Safety Formd-3000
DEPARTMENT OF RISK MANAGEMENT
INSURANCE/SAFETY APPROVAL FORM
Name
Gesette Guerra
Department
CD
Review
Status
General Liability:
Scottsdale Insurance Company
Auto Liability:
Progressive
Workers Comp:
Florida Retail Federation
Liquor Liability:
Builder Risk:
Professional Liability:
Garage Keepers Liability:
Excess Liability:
Crime Coverage
The Hartford
Pollution:
Description
De Hostos Senior Center, Inc.
Tracking #
Date:
8/25/2005
Financial
Ratings Strength REQUIREMENTS:
A+
XV
A+
XV
A+
XV
xx
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 STATUS
xx (
APPROVED /
Frank Gomez
Insurance Coordinator
Patrice Rey
Safety/ADA Coordinator
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:
Public Service contract in the amount of $110,000. City listed as additional insured and Toss payee.
Risk 002 8/25/2005 9:41 AM