Liability & Insurance

Template 16

Use Template 16 for:

Contracting with Sole Proprietor Healthcare Professionals including:

    • Physicians, Psychiatrists, etc.
    • County provides malpractice insurance.

    Contact the DHS Compliance Officer before using this template.

    When Insurance Template 16 is used, the Indemnification section of the agreement must be changed to the following:

    Indemnification. Each party shall indemnify, defend, protect, hold harmless, and release the other, its officers, agents, and employees, from and against any and all claims, loss, proceedings, damages, causes of action, liability, costs, or expense (including attorneys’ fees and witness costs) arising from or in connection with, or caused by any act, omission, or negligence of such indemnifying party. This indemnification obligation is limited to a total compensation of $1,000,000 per event.

    Mandatory Contractual Language

    Insurance requirements should be saved and attached to the contract as an exhibit. To ensure the requirements are included as part of your contract, please include the following language within the insurance section of the agreement:

    _______ is required to maintain the insurance specified in Exhibit _____, which is attached hereto and incorporated herein by this reference.

    Consistent Language

    Edit the template to keep the language consistent with your agreement.

    For example: if the template refers to: “Consultant”, but the agreement uses “Contractor”, change all references in the template to “Contractor”. If your agency is not the County (SCAPOSD, Water Agency, Fairgrounds, etc.) substitute the correct terminology for all references to “County”. If the agreement is called “contract”, “license”, “lease”, etc., edit the template to match.

    Download Template

    Template Assistant

    Section I – Insurance to be Maintained by Contractor

    With respect to performance of work under this Agreement, Contractor shall maintain and shall require all of its subcontractors, contractors, and other agents to maintain insurance as described below unless such insurance has been expressly waived by the attachment of a Waiver of Insurance Requirements. Any requirement for insurance to be maintained after completion of the work shall survive this agreement.

    County reserves the right to review any and all of the required insurance policies and/or endorsements, but has no obligation to do so. Failure to demand evidence of full compliance with the insurance requirements set forth in this Agreement or failure to identify any insurance deficiency shall not relieve Contractor from, nor be construed or deemed a waiver of, its obligation to maintain the required insurance at all times during the performance of this Agreement.

    The named insured must match the name of the entity with whom we are contracting. Some policies have several named insureds, but all insureds may not show on the certificate. If there’s no match on the certificate, request a copy of the endorsement showing the full named insured, including the entity with whom we are contracting.

    1. Workers Compensation and Employers Liability Insurance
      1. Required if Contractor has employees.
      2. Workers’ Compensation insurance with statutory limits as required by the Labor Code of the State of California.
      3. Employers’ Liability with limits of 1,000,000 per Accident; 1,000,000 Disease per employee; 1,000,000 Disease per policy.
      4. Required Evidence of Insurance Coverage: Certificate of Insurance

      If Contractor currently has no employees as defined by the Labor Code of the State of California, Contractor agrees to obtain the above-specified Workers’ Compensation and Employers’ Liability insurance should any employees be engaged during the term of this Agreement or any extensions of the term.

      If the contractor has no employees, Workers Compensation insurance is not required. The contractor is obligated to obtain the insurance if employees are hired after the inception of the agreement. A waiver is not needed if the contractor has no employees. To verify that the consultant has no employees, Risk Management recommends that you have the consultant sign the Workers Compensation Declaration (Word: 25 KB).

    2. Automobile Liability Insurance
      1. Minimum Limits: $300,000 Combined Single Limit per Accident; or Bodily Injury: $100,000 per person/$300/000 per accident and Property Damage: $50,000 per accident.
      2. Required Evidence of Insurance Coverage:
        Copy of Auto Policy Declarations Page or Certificate of Insurance.

        Contact Risk Management (Outlook: 139 kB) if the contractor is a corporation, partnership or limited liability company. For that situation the auto liability limits will need to be increased to $1,000,000 and insurance will be required for non-owned and hired autos.

        Department Waiver: You may waive this requirement if the contractor does not drive on behalf of the County.

    3. Material Breach

      If Contractor, for any reason, fails to maintain insurance coverage, which is required pursuant to this Agreement, the same shall be deemed a material breach of this Agreement. County, at its sole option, may terminate this Agreement and obtain damages from Contractor resulting from said breach. Alternatively, County may purchase such required insurance coverage, and without further notice to Contractor, County may deduct from sums due to Contractor any premium costs advanced by County for such insurance. These remedies shall be in addition to any other remedies available to County.

    4. Section II – Insurance to be Maintained by County

    5. Professional Liability Insurance

      For all activities of Contractor arising out of or in connection with services provided under this Agreement, Contractor shall be covered as a Covered Party under County’s Excess Hospital Professional Liability and General Liability Coverage. Coverage is limited to a maximum of $1,000,000 per event, $1,000,000 Annual Aggregate. County shall be responsible for the per event deductible.

    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
    Address
    575 Administration Drive
    Room 116 B
    Santa Rosa, CA 95403
    38.465237, -122.725363

    Contracts Exempt from Insurance

    Certain contracts pose low risk, therefore, they are exempt from insurance requirements.

    Learn more