Vendor Insurance InformationThe Certificate of Insurance shall name ND Paper Inc. as certificate holder using the Owner’s Oakbrook Terrace, IL address which will provide insurance coverage for the Contractor to work at one of our mill sites. ND Paper Inc. 2001 Spring Road Suite 500 Oakbrook, IL 60523 Please check off all provided coverages. Add comments for non-coverage or to clarify coverage detail. Email Address (person submitting form)* In case there are questions regarding the submission Vendor Legal Entity Name* Commercial General Liability Insurance ($5 million minimum requirement)Premises and operations liability* Owner's and Contractor's protective liability* Products and completed operation liability* Blanket contractual liability* Cross liability clause or severability of interests clause* Employer's liability* Personal injury liability* "Occurrence" basis coverage for bodily injury and property damage* "Broad form" property damage coverage, including "broad form" completed operation coverage* Loss of use of property coverage* Coverage for shoring, blasting, excavating, underpinning, demolition, pile driving, caisson work, grading, tunneling, and all work below ground surface (if applicable to the work)* Non-owned automobile liability insurance (SPF #6)* Minimum limits of liability in an amount to be agreed between the Owner and Contractor but which amount shall not be less than $5 million inclusive per occurrence of bodily injuries and property damage including loss of use thereof.* Additional Insured - The policy shall include the Owner as Additional Insured with respect to the operations of the Contractor or its Sub-contractors.* Primary Insurance - The policy shall state that the Contractor’s policy will be considered as primary insurance for all insureds thereunder and the insurer will not call into contribution any similar insurance which may be carried by the Owner* Term - If a signed Contract exists, the insurance shall be maintained continuously from commencement of the Work until all construction, erection, installation and testing has been completed and the project has been finally accepted by the Owner. The products and completed operations coverage shall be maintained for a period of 12 months after acceptance of the Work by the Owner. In the absence of a signed contract the Contractor shall provide annual insurance coverage and submit renewal certificates upon expiry to ensure continuous coverage.)* Motor and Vehicle Insurance - The Contractor shall provide and maintain during the term of the Contract, coverage for statutory motor vehicle liability insurance covering all the Contractor’s owned or leased vehicles with minimum limits of liability of $5 million inclusive per occurrence of bodily injuries and property damage.* Insurance on Contractor Equipment - The Contractor shall provide and maintain during the term of the Contract coverage under an “All Risks Property” policy covering all Contractor’s Equipment, tools and apparatus, including vessels and temporary buildings, owned or leased by the Contractor or in the care custody or control of the Contractor against all risks of direct physical loss or damage including the perils of earthquake and flood.* Waiver - The Contractor shall arrange that all policies of insurance provided by the Contractor contain a waiver of subrogation clause whereby the insurer waives its rights of subrogation against the Owner and other contractors and Sub-contractors on the Site without reference to a written contract unless both parties have previously signed a written contract.* Aircraft and Watercraft Liability Insurance - Aircraft and watercraft liability insurance shall be subject to limits of not less than $5 million inclusive per occurrence for bodily injury, death and damage to property including loss of use and limits of not less than $5 million for aircraft passenger hazard (if applicable to the work)* Notice of Cancellation or Material Change - The Contractor’s policies shall contain a clause stating that the insurer will provide the Owner with not less than 30 days notice in writing in advance of any cancellation or change restricting coverage.* Hook and Hoist Liability Insurance - If the Work includes lifting, lowering or moving of property of the Owner, the Contractor shall provide and maintain during the term of the Contract insurance covering such property for accidental loss or damage, including loss of use of property, while the property is being lifted, lowered or moved by the Contractor by the use of cranes or other lifting devices, which insurance shall be subject to limits of not less than the value of the property to a maximum of $5,000,000.* Vendor Certification of Understanding and AgreementToday's Date* MM slash DD slash YYYY Name of Authorized Signatory* Title of Authorized Signatory* I certify that the above information is accurate* Yes No If you would like a copy of your responses sent to you, please provide an email address in the field below.
