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NPS Form 10-550(Rev.11/2016) OMB Control No.1024-0268 <br /> National Park Service Expiration Date: 11/15/2019 <br /> 9. Liability and Vehicle Insurance: <br /> Provide proof of insurance. The CUA operator must maintain General Liability insurance naming the United States of America as additional <br /> insured. Minimum coverage amount is$500,000 per occurrence. Some activities will require increased coverage;see Park-Specific CUA <br /> Insurance Requirements("Attachment B"). Auto Liability insurance is required,if applicable,in the minimum coverage amounts described <br /> below. <br /> COMMERCIAL GENERAL LIABILITY INSURANCE <br /> Single Purpose Activities(includes day and overnight hiking,photography and art $500,000 <br /> classes,bicycling,and group camping) <br /> Commercial Vehicle Insurance—Passenger Transport Minimum per Occurrence Liability Limits* <br /> (bodily injury and property damage) <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(for intrastate operations only). <br /> 10. Will your business operate vehicles(car,truck,van,bus,taxicab,vessel,aircraft,etc.)within NPS boundaries? <br /> Yes No <br /> If"Yes,"please give a description of each vehicle. Use additional paper,if necessary. All vehicles are required to be registered and the <br /> operators are required to have the proper licenses to operate them commercially,as required by law or regulation. <br /> Make/Model of Vehicle License Number Year Max#Passenger Capacity Own/Rent <br /> Ford Transit 68309D 2018 14 Own <br /> Ford E450 Superduty 52306D 2011 14 Own <br /> Ford E350 Clubwagon 58124D 2003 12 Own <br /> Make of Aircraft Tail Number Max#Passenger Capacity Own/Rent <br /> Registration Number or <br /> Make/Model of Vessel USCG Documentation Length Max#Passenger Capacity Own/Rent <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 license,fishing <br /> license,vessel registration,dive certification,CPR certification,or others. Provide copies of licenses and certifications required by <br /> "Attachment A". <br /> 12. NPS Employment: <br /> Are you,your spouse,or minor children employed within the National Park Service? <br /> Yes ❑ No ® If"Yes",please provide information below: <br /> Employee Name: Title: <br /> Park and Office Where Employed: <br /> NPS Form 10-550(Rev.11/2016) OMB Control No.1024-0268 <br /> National Park Service Expiration Date: 11/15/2019 <br />