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6.3. Indemnification and Insurance
INSURANCE REQUIREMENTS -PROFESSIONAL SERVICES AGREEMENT(S)
HEALTH BENEFIT CONSULTING SERVICE AND ACTUARIAL SERVICES
I. Commercial General Liability
A Limits of Liability .... .........._,..... ..
Bodily Injury and Property Damage Liability
Each Occurrence $1,000,000
General Aggregate Limit $ 2,000,000
Personal and Adv. Injury $ 1,000,000
Products/Completed Operations $ 1,000,000
B. Endorsements Required
City of Miami included as an Additional Insured
Employees included as insured
Contractual Liability
Waiver of Subrogation
II. Business Automobile Liability
A. Limits of Liability
Bodily Injury and Property Damage Liability
Combined Single Limit
Any Auto
Including Hired, Borrowed or Non -Owned Autos
Any One Accident $ 1,000,000
B. Endorsements Required
City of Miami included as an Additional Insured
III. Worker's Compensation
Limits of Liability
Statutory -State of Florida
Waiver of Subrogation
IV. Employer's Liability
A. Limits of Liability
$100,000 for bodily injury caused by an accident, each accident
$100,000 for bodily injury caused by disease, each employee
$500,000 for bodily injury caused by disease, policy limit
V. Professional Liability/Errors and Omissions Coverage
Combined Single Limit
Each Claim $ 1,000,000
General Aggregate Limit $ 2,000,000
Deductible- not to exceed 10%
The above policies shall provide the City of Miami with written notice of cancellation or
material change from the -insurer not lessthan.(30)- days prior -to any -such cancellation or..____.
-- material change.... _... ,.-..
Companies authorized to do business in the State of Flonda, with the following qualifications,
shall issue all insurance policies required above:
The company must be rated no less than "A" as to management, and no less than "Class V" as to
Financial Strength, by the latest edition of Best's Insurance Guide, published by A.M. Best
Company, Oldwick, New Jersey, or its equivalent. All policies and /or certificates of insurance
are subject to review and verification by Risk Management prior to insurance approval.
The undersigned Proposer acknowledges that (s)he has read the above information and agrees to
comply with all the above City requirements.
Proposer: Signature:
(Company name)
Date: Print Name:
FAILURE TO COMPLETE, SIGN, AND RETURN THIS FORM MAY DISQUALIFY
YOUR RESPONSE.
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6.4. Local Office Affidavit
Please type or print clearly. This Affidavit must be completed In fuIt, signed and notarized ONLY if your office Is located within the
corporate limits of the City of Miami,
Legal Name of Firm:
Entity Type: (check one box only) (] Partnership
[] Sole Proprietorship () Corporation
_Corporation Doc.Date .Established:_._..._...._........Occupational.L,i.eense.Nn:._....__ ._.,..._.Data
PRESENT
Street Address:
City:
State:
How long at this location:
PREVIOUS
Street Address:
City:
State
How long at this location:
According to Ordinance No. 12271 (Section 18-85):
The City Commission may offer to a responsible and responsive local bidder, who maintains a Local Office, the opportunity of accepting a bid at
the low bid amount, if the original bid amount submitted by the local vendor is not more than ten percent (l0[a) in excess of the lowest other
responsible and responsive bidder.
The intention of this section is to benefit local bona fide bidders/proposers to promote economic development within the corporate limits
of the City of Miami.
1 (we) certify, under penalty of perjury, that the office location of our firm has not been established with the sole purpose of obtaining the
advantage granted bona tide local bidders/proposers by this section.
(o:rl oarattr Seal)
Authorize Signature
Print Name
Title
Authorize Signature
Print Name
Title
(Must be signed by the corporate secretary of a Corporation or one general partner of a partnership or the proprietor of a sole proprietorship or all
partners of a joint venture;)
STATE OF FLORIDA, COUNTY OF MIAMI-DADE
[} Personally known to me; or
Subscribed and Sworn before me that this is a true statement this day of 200 . [} Produced identification:
Notary Public, State of Florida My Commission expires
Printed name of Notary Public
Please submit with your bid copies of Occupational License, professional and/or trade License to verify local status. The City of Miami
also reserves the right to request a copy of the corporate charter, corporate income tax tiling return and any other documents(s) to verify
the location of the firm's office location.
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