Template 30

Use Template 30 for:

Temporary Self-Fueling Permit -- Rental Cars

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.

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 30
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Permittee shall maintain and require its subcontractors and agents to maintain insurance as described below unless such insurance has been expressly waived by the attachment of a Waiver of Insurance Requirements. If Permittee maintains a program of self-insurance, Permittee shall obtain County’s approval of Permittee’s self-insurance program prior to inception of this Permit 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 Permit Agreement or failure to identify any insurance deficiency shall not relieve Permittee from, nor be construed or deemed a waiver of, its obligation to maintain the required insurance at all times during the performance of this Permit Agreement.

1. Workers Compensation and Employers Liability Insurance
   1. Workers Compensation insurance with statutory limits as required by the Labor Code of the State of California.
   2. Employers Liability with minimum limits of $1,000,000 per Accident; $1,000,000 Disease per employee; $1,000,000 Disease per policy.
   3. The policy shall be endorsed to include a written waiver of the insurer's right to subrogate against County.

      If a permittee’s employee is injured on the job, the workers compensation insurer will cover the claim. However, if the County is in any way responsible for causing that injury, the insurer will try to recover all or part of its payment from us. This is called subrogation. The insurer cannot recover from us if it has waived its right to subrogate.

   4. Required Evidence of Insurance:
      1. Subrogation waiver endorsement; and
      2. Certificate of Insurance.
2. General Liability Insurance
   1. Commercial General Liability Insurance on a standard occurrence form, no less broad than Insurance Services Office (ISO) form CG 00 01.

      ISO (Insurance Services Office) publishes a standard CGL. Some insurers use that specific form; others use their own form with a different numbering system. Any CGL is acceptable as long as the coverage is as broad as the ISO form.

      An occurrence policy responds if the injury or damage takes place during the policy period. It doesn’t matter when the claim is filed.

      A claims-made policy responds if the claim (demand for money) is made during the policy period.

   2. Minimum Limits: $1,000,000 per Occurrence; $2,000,000 General Aggregate; $2,000,000 Products/Completed Operations Aggregate. The required limits may be provided by a combination of General Liability Insurance and Commercial Umbrella Liability Insurance. If Permittee maintains higher limits than the specified minimum limits, County requires and shall be entitled to coverage for the higher limits maintained by Permittee.

      Occurrence limit: the most the insurer will pay for any one accident.

      General Aggregate: the most the company will pay for all claims resulting from damage or injuries that occur before the work is completed, regardless of the number of accidents, injuries, claims or claimants.

      Products/Completed Operations Aggregate: the most the insurer will pay for all claims resulting from damage or injuries that occur after the work is completed, regardless of the number of accidents, injuries, claims or claimants.

      A Commercial Umbrella or Excess Liability policy provides additional limits which are usually shown on the Certificate of Insurance. The additional limits are added to the General Liability Limits. The combined total of the Excess or General Liability Limits and the Umbrella Limits must equal or exceed our minimum requirements.

   3. Any deductible or self-insured retention shall be shown on the Certificate of Insurance. If the deductible or self-insured retention exceeds $25,000 it must be approved in advance by County. Permittee is responsible for any deductible or self-insured retention and shall fund it upon County’s written request, regardless of whether Permittee has a claim against the insurance or is named as a party in any action involving the County.
   4. The County of Sonoma, its officers, agents and employees shall be endorsed as additional insureds for liability arising out of Permittee's ongoing operations. (Acceptable endorsements: ISO endorsement CG 20 26, ISO endorsement CG 20 12 or equivalents.)

      We must get a copy of the endorsement or section of the policy that makes us an additional insured. A statement on the Certificate of Insurance is not sufficient because an insurance company is bound by its policy and endorsements, not by the Certificate.

      Additional insured endorsements which do not include our name are acceptable if they have language granting additional insured status to parties for whom our vendor (or consultant, contractor, permittee, licensee, tenant, etc.) is required to provide additional insured status under a contract or agreement. Submit a HelpRequest if you’re not sure the endorsement is acceptable.

      ISO endorsement CG 20 26 covers the County for liability arising out of the Permittee’s ongoing operations or liability arising from premises rented to the Permittee.

      Endorsement CG 20 12 covers the County for liability arising out of the Permittee’s operations for which we have issued a permit or authorization.

      Not acceptable – CG 20 10: "additional insured...but only with respect to liability...in the performance of your ongoing operations FOR the additional insured(s)." With this language we are not an additional insured because the Permittee is not doing any work for us.

   5. The insurance provided to the additional insureds shall be primary to, and non-contributory with, any insurance or self-insurance program maintained by them.

      Because the County is an additional insured on the Permittee’s policy, we want that policy to cover claims before any contribution from County’s CSAC protection or its self-insured retention.

      We must get a copy of the endorsement or section of the policy that has the Primary & Non-Contributory language. statement on the Certificate of Insurance is not sufficient because an insurance company is bound by its policy and endorsements, not by the Certificate.

   6. The policy shall cover inter-insured suits between County and Permittee and include a “separation of insureds” or “severability” clause which treats each insured separately.

      This guarantees that the County will be covered if it is sued by the Permittee and that the Permittee will be covered if it is sued by the County. This language is standard in the General Liability policy; you do not need to get a specific endorsement to satisfy this requirement.

   7. Required Evidence of Insurance:
      1. Copy of the additional insured endorsement or policy language granting additional insured status;
      2. Copy of the endorsement or policy language indicating that insurance is primary and non-contributory; and
      3. Certificate of Insurance.
3. Automobile Liability Insurance
   1. Minimum Limit: $1,000,000 combined single limit per accident.
   2. Insurance shall apply to all owned, hired and non-owned vehicles.

      Hired Autos: vehicles the Permittee rents or borrows.

      Non-owned Autos: vehicles owned or operated by the Permittee’s employees, subcontractors, agents, vendors, suppliers or exhibitors.

      If "Any Auto" is checked on the Certificate of Insurance, it includes owned, hired and non-owned autos.

   3. Required Evidence of Insurance: Certificate of Insurance.
4. Pollution/Environmental Impairment Liability Insurance
   1. Minimum Limit: $1,000,000 per pollution condition. If Permittee maintains limits higher than the specified minimum limits, County requires and shall be entitled to coverage for the higher limits maintained by Permittee.
   2. The insurance shall provide coverage for:
      1. bodily injury, sickness or disease, sustained by any person, including death;
      2. property damage, including physical injury to or destruction of tangible property including the resulting loss of use thereof;
      3. cleanup costs, and the loss of use of tangible property that has not been physically injured or destroyed including diminution of value and natural resources damages;
      4. defense costs including costs, charges, and expenses incurred in the investigation, adjustment, or defense of claims: and
      5. liability assumed by Permittee under a written contract or agreement.
   3. The County of Sonoma, its officers, agents and employees shall be endorsed as additional insureds for liability arising out of Permittee’s operations under this Permit Agreement;

      We must get a copy of the endorsement or section of the policy that makes us an additional insured. A statement on the Certificate of Insurance is not sufficient because an insurance company is bound by its policy and endorsements, not by the Certificate.

   4. The insurance provided to the additional insureds shall be primary to, and non-contributory with, any insurance or self-insurance program maintained by them.

      Because the County is an additional insured on the permittee’s policy, we want that policy to cover claims before County’s self-insured retention or its pollution policy contribute to the claim. To put it another way: the permittee’s policy pays first.

      We must get a copy of the endorsement or section of the policy that has the Primary & Non-Contributory language. A statement on the Certificate of Insurance is not sufficient because an insurance company is bound by its policy and endorsements, not by the Certificate.

   5. If the insurance is on a Claims-Made basis, the retroactive date shall be no later than the date of this Permit Agreement.
      In a claims-made policy the claim (demand for money) has to be made during the policy period. However, the injury or damage must occur on or after the retroactive date. The retroactive date is usually the inception date of the first claims-made policy purchased by the Permittee.
   6. If the insurance is on a Claims-Made basis, the insurance shall be maintained for two (2) years after termination of this Permit Agreement. Continuation insurance may be provided by: (a) renewal of the existing policy; (b) an extended reporting period endorsement; or (c) replacement insurance with a retroactive date no later than the inception of this Permit Agreement.
   7. Any deductible or self-insured retention shall be shown on the Certificate of Insurance. If the deductible or self-insured retention exceeds $25,000 it must be approved in advance by County. Permittee is responsible for any deductible or self-insured retention and shall fund it upon County’s written request, regardless of whether Permittee has a claim against the insurance or is named as a party in any action involving the County.

      Contact Risk Management if the retention or deductible exceeds $25,000. We want to verify that the party with whom we are contracting has sufficient assets to fund a large retention or deductible. No waiver is needed.

      There is no specific field on the Certificate of Insurance for a Pollution Liability deductible or retention.

   8. The policy shall be endorsed to include a written waiver of the insurer's right to subrogate against all persons or entities that are, or are required to be, additional insureds.
   9. Required Evidence of Insurance:
      1. Copy of the additional insured endorsement or policy language granting additional insured status;
      2. Copy of the endorsement or policy language indicating that insurance is primary and non-contributory;
      3. Subrogation waiver endorsement; and
      4. Certificate of Insurance.
5. Standards for Insurance Companies
   Insurers, other than the California State Compensation Insurance Fund, shall have an A.M. Best's rating of at least A:VII.
   A.M. Best’s is one of the services that reviews insurers’ financial information. We want the insurer to be able to pay its claims. The letter (A+, A, A-, B+, etc.) is Best’s rating of financial strength. The number (XII, VII, etc.) refers to the insurer’s financial size. You can check the rating at: http://www.ambest.com/ - the service is free, but you need to register and log in. 

   Department Waiver: You may waive the A.M. Best’s rating if an insurer’s rating is below A:VII.

6. Documentation
   1. The Certificate of Insurance shall include the following reference: [insert reference].
   2. All required Evidence of Insurance shall be submitted prior to the execution of this Permit Agreement. Permittee agrees to maintain current Evidence of Insurance on file with County for the required period of insurance.
   3. The name and address for Additional Insured endorsements and Certificates of Insurance is: [ insert exact name and address].
   4. Required Evidence of Insurance shall be submitted for any renewal or replacement of a policy that already exists, at least ten (10) days before expiration or other termination of the existing policy.
   5. Permittee shall provide immediate written notice if: (1) any of the required insurance policies is terminated; (2) the limits of any of the required policies are reduced; or (3) the deductible or self-insured retention is increased.
   6. Upon written request, certified copies of required insurance policies must be provided within thirty (30) days.
7. Policy Obligations
   Permittee's indemnity and other obligations shall not be limited by the foregoing insurance requirements
8. Material Breach
   If Permittee fails to maintain insurance which is required pursuant to this Permit Agreement, it shall be deemed a material breach of this Permit Agreement. County, at its sole option, may terminate this Permit Agreement and obtain damages from Permittee resulting from said breach.