Liability & Insurance

Sample Form 6: Additional Insured – Ongoing and Completed Operations

Who Is An Insured - "…liability arising out of "your work" for that insured…" We are protected only if they are doing the work FOR us.
Who Is An Insured Schedule - The endorsement will typically have a place to fill in our name plus the location of the job. Both will have to be completed or we have no protection.

Contact Information

Jamie Bloom, Insurance Manager

Katie MacKay, 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

Sample Form

Additional Insured – Ongoing and Completed Operations

Sample Form

Image of sample form with field definitions and explanations.