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Contract #31300 <br />City of Santa Ana AJCC <br />7) Inadequate Insurance — Inadequate or lack of insurance does not negate <br />the Contractor's obligations under the Agreement. <br />B. Insurance Coverage <br />1) Commercial General Liability -- Contractor shall maintain general liability on <br />an occurrence form with limits not less than $1,000,000 per occurrence for <br />bodily injury and property damage liability combined with a $2,000,000 <br />annual policy aggregate. The policy shall include coverage for liabilities <br />arising out of premises, operations, independent contractors, products, <br />completed operations, personal & advertising injury, and liability assumed <br />under an insured Agreement. This insurance shall apply separately to each <br />insured against whom claim is made or suit is brought subject to the <br />Contractor's limit of liability. The policy must include: <br />(Agency/Department Name), The State of California, its officers, agents, <br />employees and servants as additional insured, but only with respect to work <br />performed under the Agreement. <br />Endorsements must be physically attached to all requested <br />certificates of insurance and not substituted by referring to such <br />coverage on the certificate of insurance. The endorsement must be <br />acceptable to the DGS Office of Risk and Insurance Management. <br />2) Workers Compensation and Employers Liability — Contractor shall maintain <br />statutory worker's compensation and employer's liability coverage for all its <br />employees who will be engaged in the performance of the Agreement. <br />Employer's liability limits of $1,000,000 are required. <br />The workers' compensation policy shall contain a waiver of <br />subrogation in favor of the State. The waiver of subrogation <br />endorsement shall be provided <br />3) If your business is a Sole Proprietorship and does not employ any other <br />individual(s), a signed statement on business letterhead stating: <br />"I certify under penalty of perjury under the laws of the State of California <br />that I do not employ any person in any manner as to become subject to the <br />Workers' Compensation laws of California. 1 further certify that the <br />Department of Rehabilitation will be notified within ninety (90) days of any <br />changes which results in the business becoming subject to the Workers' <br />Compensation laws of the State of California" must be on file for this <br />agreement <br />Exhibit D <br />