Liability & Insurance

Sample Form 1: Certificate of Liability Insurance

Insured -The named insured must match the legal name on our contract.
General Liability: Occur -Occurrence is required.
Policy Effective and Expiration Dates -Dates must be current.
General Liability: LOC - Should be "per project" for construction and construction-related contractors.
Automobile Liability: Any Auto -Any Auto = Owned + Hired + Non-owned autos.
Umbrella & Excess Liability - Umbrella and excess limits are added to the General Liability and Auto Limits.
Empty space under Type of Insurance - Professional & Pollution or Environmental Liability are often listed here.
Description of Operations, Locations, Vehicles -The contract number, project name or other identifier should be here.
Certificate Holder -Should match the name & address specified in the Template.

Contact Information

Jamie Bloom, Insurance Manager

Reesha Ruel, Liability Manager

Risk Management Division

Human Resources Department

Business Hours
Monday – Friday
8:00 AM – 5:00 PM
Contact us by Phone
575 Administration Drive
Room 116 B
Santa Rosa, CA 95403
38.465237, -122.725363

Download Printable Version