Sample Exhibit

Sample Exhibit
The contractor shall purchase and maintain in full force and effect insurance policies with the limits of
insurance provided in the contract documents or the following insurance coverage’s, whichever is greater.
The insurance should be from an insurer that has an A.M. Best Rating of “A” or better.
1.
2.
3.
4.
5.
6.
Commercial General Liability with limits not less than $1,000,000 per occurrence, $2,000,000
general aggregate, $1,000,000 and $2,000,000 products-completed operations aggregate.
Such insurance shall cover liability arising from premises, operations, independent
contractors, product-completed operations, personal and advertising injury and liability
assumed under an insured contract. There shall be no endorsement or modification of the
Commercial GL form arising from pollution, explosion, collapse, underground property
damage or work performed by contractors.
Commercial General Liability shall include a per project aggregate endorsement.
Business Automobile Liability with a limit of not less than $1,000,000 each accident,
including owned, non-owned, leased and hired vehicles.
Statutory Workers Compensation & employers liability coverage for all employees,
including corporate officers and sole proprietors.
Contractors Equipment Coverage - The contractor is responsible to maintain insurance on their
tools and equipment.
Umbrella/Excess Liability with a limit of not less than $1,000,000 per occurrence/aggregate
(unless higher limits are required by the Owner).
Greenbush Youth Soccer Club, Inc. and it’s President, Officers, Directors, Members, Players, Visitors and
it’s Successors are to be included as additional insured’s on a primary, non-contributory basis (using CG
2010 11/85 or it’s equivalent) for item 1, including products-completed operations coverage for 3 years,
and for items 3 and 6.
No insurance policies obtained in accordance with this paragraph shall exclude coverage for liability
resulting from application of either Section 240 or Section 241 of the New York State Labor Law. A copy
of the Additional Insured endorsement should be provided to Greenbush Youth Soccer Club, Inc.
Contractor agrees to require any and all subcontractors hired to perform work on the project to obtain
insurance coverage as provided above. All such insurance coverage shall name Greenbush Youth Soccer
Club, Inc. as an Additional Insured on a primary, Non-contributory basis on form CG 2010 11/85 or its
equivalent. The foregoing coverage’s and limits are to be considered as minimum requirements and in no
way limit the liability of the Subcontractor.
All policies required by this paragraph shall include a waiver of subrogation in favor of Greenbush Youth
Soccer Club, Inc. and others as listed above.
All policies and certificates of insurance shall expressly provide that Greenbush Youth Soccer Club, Inc.
must receive 30 days written notice in the event of material alteration, cancellation or nonrenewal of
coverage.
Indemnification
INDEMNIFICATION AGREEMENT (“Agreement”) dated as of the ____ day of __________, 20__, (the
“Effective Date”) by and between Greenbush Youth Soccer Club, Inc. with a principal business address at
_____________________________________ (the “Owner”) and ____________________ with a principal
business address at _______________________ (the “Subcontractor”), attached to and forming a part of
the contract between the Greenbush Youth Soccer Club, Inc. and the Subcontractor with respect to the
project and/or site owned by ___________________ with a principal business address at
___________________________
(the
“Owner”)
and
located
at
_________________________________________. In consideration of the mutual promises contained
herein and other good and valuable consideration, the receipt and sufficiency of which is acknowledged,
Greenbush Youth Soccer Club, Inc.and Subcontractor agree as follows:
To the fullest extent permitted by law, the Subcontractor shall indemnify, defend and hold harmless the
Greenbush Youth Soccer Club, Inc.and the Owner, and each of their officers, directors, shareholders,
employees and agents from and against any and all claims, actions, damages, losses and expenses,
including but not limited to attorney’s fees, for any actual or alleged injury to any person or persons,
including death, or damage to or destruction of property arising out of any act or omission on the part of the
Subcontractor, its employees, agents or subcontractors in connection with any work or services performed
on behalf of the Greenbush Youth Soccer Club, Inc.or the Owner.
In the event any provision of this Agreement is held to be unenforceable or voidable by a court of
competent jurisdiction, the enforceability of the remaining provisions shall not be affected and, in lieu of
such unenforceable or voidable provision, there shall be added automatically provisions as similar in terms
as may be enforceable under applicable law.
IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of the Effective Date.
Greenbush Youth Soccer Club, Inc.
_______________________
By:____________________
Title:___________________
Subcontractor
_______________________
By:_____________________
Title:____________________
PLEASE NOTIFY YOUR INSURANCE COMPANY OF THE ABOVE.