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SECTION 4: INSURANCE COVERAGE – please check the appropriate box below to indicate if your entity can obtain each <br />type of coverage. (Waivers may be granted in some instances.) If your project is selected, please submit your proof of <br />insurance upon request. <br />Type Agency CAN obtain this <br />coverage <br />Agency CANNOT <br />obtain this coverage <br />Public Liability Insurance - $1,000,000 personal injury and property <br />damage <br />Worker’s Compensation Coverage – as required by the State of <br />Washington <br />Professional Liability – Only required when providing professional <br />services, $1,000,000 error and omissions. <br />Self-Insured – Public Entities ONLY <br />SECTION 5: FINAL QUESTIONS – HAVE YOU… <br />Completed all form questions YES NO <br />Confirmed desired project is in the appropriate budget documents YES NO <br />Confirmed desired project is in your CIP YES NO <br />Reviewed the agreement template YES NO <br />Confirmed Proof of Insurance YES NO <br />SECTION 6: SUBMISSION REQUIREMENTS <br />Please submit the form and all requested attachments to the following address by Ju , 5 PM <br /> <br />3000 Rockefeller Avenue, M/S 609 <br />Everett, WA 98201-4046