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131030 Sewer Insurance Policy
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131030 Sewer Insurance Policy
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Last modified
11/21/2013 8:53:53 AM
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11/21/2013 8:53:34 AM
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Board of Public Works
Document Date
11/12/2013
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Equipment On Hand <br /> (Provide proof of ownership and <br /> list of equipment owned by <br /> company for use in determination <br /> of pre-qualification) <br /> By signing and submitting this application, I/we agree to follow all City of South Bend Prevailing <br /> Specifications and Special Provisions (enclosed in the Sewer Insurance Program Policy as Exhibit G) <br /> By signing and submitting this application for pre-qualification, Uwe understand that as a Contractor <br /> under the City Sewer Insurance Program, I/we shall be directly and solely liable to a Homeowner for any <br /> damage to any Homeowner's person or property caused by the Contractor's acts, conduct or omissions <br /> arising from or within the scope of this Program. I/we shall release and fully indemnify the City from any <br /> claim or cause of action of any kind which Homeowner may make against the City for any act, conduct or <br /> omission by the Contractor under this Program. Indemnification includes but is not limited to <br /> Contractor's payment of any legal fees or legal expense incurred by the City in defending such <br /> Homeowner claim. <br /> Signature Signature Signature <br /> Title Title Title <br /> Dote Dote Dote <br /> 13 <br />
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