Contractor Proof of Insurance. Contractor shall provide the following information upon submission of the signed Contract. All insurance listed herein and required by Exhibit C must be in effect prior to Contract execution. Commercial General Liability Insurance Company: Policy #: Expiration Date: Workers’ Compensation: Does Contractor have any subject workers, as defined in ORS 656.027? (Check one box): YES NO If YES, provide the following information: Workers’ Compensation Insurance Company: Policy #: Expiration Date:
Contractor Proof of Insurance. Contractor shall provide the following information upon submission of the signed Contract. All insurance listed herein and required by Exhibit C must be in effect prior to Contract execution. Professional Liability Insurance Company: Policy #: Expiration Date: Commercial General Liability Insurance Company: Policy #: Expiration Date: Automobile Liability Insurance Company: Policy #: Expiration Date: Workers’ Compensation: Does Contractor have any subject workers, as defined in ORS 656.027? (Check one box): YES NO If YES, provide the following information: Workers’ Compensation Insurance Company: Policy #: Expiration Date:
Contractor Proof of Insurance. Contractor shall provide the following information upon submission of the signed Contract. All insurance listed herein and required by Exhibit C, must be in effect prior to Contract execution. Professional Liability Insurance Company: Policy #: Expiration Date: Commercial General Liability Insurance Company: Policy #: Expiration Date: Automobile Liability Insurance Company: Policy #: Expiration Date: Network Security and Privacy Liability: Policy #: Expiration Date: Physical Abuse and Molestation Insurance Coverage: Policy #: Expiration Date: Workers’ Compensation: Does Contractor have any subject workers, as defined in ORS 656.027? (Check one box): YES NO If YES, provide the following information: Workers’ Compensation Insurance Company: Policy #: Expiration Date:
Contractor Proof of Insurance. All insurance listed must be in effect at the time of provision of services under this Contract.
Contractor Proof of Insurance. Contractor shall provide the following information upon submission of the signed Contract. All insurance listed herein and required by Exhibit C, must be in effect prior to Contract execution. Professional Liability Insurance Company: PROPOSERS, DO NOT COMPLETE OR RETURN THIS PAGE WITH PROPOSAL Policy #: Expiration Date: Commercial General Liability Insurance Company: Policy #: Expiration Date: Automobile Liability Insurance Company: Policy #: Expiration Date: Other #1 (list type of coverage and Company): Policy #: Expiration Date: Other #2 (list type of coverage and Company): Policy #: Expiration Date: Workers’ Compensation: Does Contractor have any subject workers, as defined in ORS 656.027? (Check one box): YES NO If YES, provide the following information: Workers’ Compensation Insurance Company: Policy #: Expiration Date:
Contractor Proof of Insurance. Contractor shall provide the following information upon submission of the signed Contract. All insurance listed herein and required by Exhibit C must be in effect prior to Contract execution. If Contractor is self-insured for any of the Insurance Requirements specified in Exhibit C of this Contract, Contractor may so indicate by: (i) writing “Self-Insured” on the appropriate line(s); and
