Laserfiche WebLink
NPS Form 10-550(Rex 11/2016) OM13 Control No. 1024-0268 <br /> National Park Service Expiration Date: 11/15/2019 <br /> America as additional insured. Minimum coverage amount is$500,000 per occurrence. Some activities will require <br /> increased coverage; see Park-Specific CUA Insurance Requirements ("Attachment B").Auto Liability insurance is also <br /> required at the minimum coverage amounts described below. <br /> "' COMMERCIAL GENERAL LIABILITY INSURANCE <br /> Single Purpose Activities (includes day and overnight hiking, photography and $500,000 <br /> art classes, bicycling, and group camping) <br /> Climbing $1,000,000 <br /> Commercial Vehicle Insurance—Passenger Transport Minimum per Occurrence Liability <br /> (bodily injury and property damage) Limits* <br /> Up to 6 passengers $1,000,000 <br /> 7— 15 passengers $1,500,000 <br /> 16—25 passengers $3,000,000 <br /> 26+ passengers $5,000,000 <br /> Indicated minimum per occurrence liability limit or minimum State liability requirement in State of operation, whichever is <br /> greater. <br /> 10. Will your business operate vehicles(car, truck, van, bus,taxicab, vessel, aircraft, etc.)within NPS boundaries?Yes X No <br /> If"Yes,"please give a description of each vehicle. Use additional paper, if necessary. All vehicles are required to be <br /> registered and the operators are required to have the proper licenses to operate them commercially, as required by law or <br /> regulation. <br /> Make/Model of Vehicle License Number Year Max#Passenger Capacity Own/Rent <br /> Ford E450 52306D 2011 14 Own <br /> Ford E350 58124D 2003 12 Own <br /> Ford Transit 68309D 2018 14 Own <br /> 11. Employee Licenses and Certifications: <br /> Parks typically require proof of applicable licenses, registrations and certificates of training, such as; valid driver's or pilot's <br /> license,fishing license, vessel registration, dive certification, CPR certification, or others. Provide copies of licenses and <br /> certifications required by"Attachment A". <br /> 12. NPS Employment: <br /> Are you, your spouse, or minor children employed within the National Park Service? <br /> Yes E No X If"Yes", please provide information below: <br /> Employee Name: Title: <br /> Park and Office Where Employed: <br /> Page 5 of 22 <br />