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MEMORANDUM <br />Purchasing/Risk Management <br />APPROVED <br />TO: PURCHASING SERVICES/RISK MANAGER <br />FROM: Public Works -Sewer (WQCP) <br />CC: <br />RE: REQUEST TO WAIVE INSURANCE REQUIREMENTS <br />Insurance requirements for vendors providing goods and services, instructors, contractors <br />and consultants may be waived by the City Manager or his/her designee (Risk Management) <br />on a case-by-case basis if the vendor establishes to the satisfaction of the City Manager that <br />the cost of obtaining insurance is financially prohibitive, it is impossible to obtain insurance <br />coverage or other circumstances as described below (per Section 601(d) and Section 1105 <br />of the City Charter). To make this process efficient and easy to use by the requesting <br />departments, please completely fill out this form and send to the Risk Management Division <br />at least five (5) business days before committing to the delivery of the goods or performance <br />of the service. <br />********************************************************************************************************* <br />Please consider waiving insurance as follows: <br />Purchase Requisition or Purchase :Y206693 <br />Order Number: <br />Vendor name: <br />Detailed scope of work or goods <br />and services provided: <br />Time frame of services to be <br />provided: <br />Check all that apply: <br />Commercial General Liability <br />❑ The work being performed is done solely on vendor's premises. <br />❑ The work being performed does not involve use of dangerous equipment, etc. <br />0 Other: Software maint. renewal - Vendor does not have access to City System. <br />