HomeMy WebLinkAboutInsurance-Safety Approval FormDEPARTMENT OF RISK MANAGEMENT
INSURANCE/SAFETY APPROVAL FORM
Name
Gesette Guerra
Department
CD
Review
Status
Commercial General Liability
Hired and Non Owned Autos
Workers Comp:
Liquor Liability:
Builder Risk:
Professional Liability:
Garage Keepers Liability:
Excess Liability: //
i
/
Crime Coverage / /
Pollution: /
Description
Henry Farmer, d/b/a T. Express Janitorial Service
Tracking #
Date:
9/8/2006
Financial
Ratings Strength REQUIREMENTS:
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 ST4TUS
xx APPROVED
Frank Gomez
P&C Coordinator
Patrice Rey
Safety Manager
Not Approved
Coverage is insufficient
Not A Rated Company
A Type of Coverage is Missing
Other
The City NOT Named Additional Insured
4hsurance/Safety Comments:
Micro -Enterprise Assistance Agreement (CDBG funding in the amount of $5,000.)
No insurance is required.
Risk 002 9/8/2006 10:39 AM