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µ (r. <br />Steps: (a) Obtain Copy of (Current) Contract; (b) Identify Insurance Paragraph in Contract-, <br />(c) Review Insurance Requirements Stated in the Contract and Compare with the Certificate of <br />Insurance Submitted for Approval; and (d) Check-off Each Item Below During Your Review of <br />the Submitted Certificate of Insurance: <br />IV 1. Name and Address of a Producer X, 7. Policy Number and Check to Verify <br />Insurance is Effective During Project Date <br />Ki 2. Name and/or Telephone Number for or Contract Tenn <br />Producer Contact <br />[A 3. Name and Address of Contractor <br />1XI 4. Name of the Insurance Company(ics) <br />14, 5. Boxes Checked Identifying the Type of <br />Coverage <br />KI 6. Additional Insured Box May be Checked <br />and Separate Additional Insured <br />Endorsement Form Must Be Attached (make <br />sure the endorsement lists the insurance <br />policy #) and Verify Primary Language on <br />Acceptable Additional Insured Endorsement <br />(� 8. Correct Coverage Dollar Amounts Listed <br />9. Project Description by Number or Location <br />(if applicable) <br />IX 10. Name of City and Address <br />11. Insurer's Signature Required <br />(not the contractor's signature) <br />KI 12. To Approve, Write "Reviewed. by [sign <br />your name]" on. Every Page of the <br />Certificate of Insurance and all <br />Endorsements and Write the Number of <br />Pages (ex. 1/4 or 4/4) <br />1 <br />Contact the City Attorney's Office if you have any questions — Lisa Storck x 5207 <br />.S <br />