Aviation Owner Controlled Insurance Program Manual

AVIATION OWNER CONTROLLED

INSURANCE PROGRAM MANUAL

JANUARY 2016 EDITION

RISK MANAGEMENT DEPARTMENT

This manual is a contract document

METROPOLITANWASHINGTONAIRPORTS AUTHORITY

Aviation Owner Controlled Insurance Program Manual(January 2016 Edition)

This manual is intended to provide only a general overview of the Aviation OwnerControlled Insurance Program for various airport and toll road constructionprojects and does not in any way alter or take precedence over the language inthe actual insurance policies and contracts. It makes no promise to provideinsurance to those not enrolled in the Aviation Owner Controlled Insurance

Program. The Metropolitan Washington Airports Authority and its agents shouldnot be deemed as insurers of safety or as having an overriding safety duty at anyof the job sites.

.nthonyU^ Vegliant(Vice President of Human Resources and

Administrative Services

January 2016

Date

METROPOLITAN WASHINGTON AIRPORTS AUTHORITYAVIATION OCIP Insurance Manual January 2016 Edition

METROPOLITAN WASHINGTON AIRPORTS AUTHORITY AVIATION OCIP Insurance Manual January 2016 Edition

This page reserved for future use.

T A B L E O F C O N T E N T S

METROPOLITAN WASHINGTON AIRPORTS AUTHORITY AVIATION OCIP Insurance Manual January 2016 Edition ii

TABLE OF CONTENTS Overview ............................................................................................ 1

Discontinuation of AVIATION OCIP ........................................................... 2 Modification of AVIATION OCIP ................................................................ 2 Safety Obligations ...................................................................................... 3

Contracts For Terminal B/C Long-Term Redevelopment ................................... 4 Contracts Awarded After 03/01/2016 (non-Terminal B/C Long-Term Redevelopment) ........... 5 Contracts Awarded Prior To 03/01/2016 (non-Terminal B/C Long-Term Redevelopment) ...... 6

AVIATION OCIP Directory ................................................................ 7 AVIATION OCIP Definitions ............................................................. 8 AVIATION OCIP Insurance Coverage ............................................ 11

Enrolled Parties ........................................................................................ 11 Excluded Parties ...................................................................................... 11 Evidence of Coverage .............................................................................. 11 Summary Description of AVIATION OCIP Coverage ............................... 12

Primary Commercial General Liability Coverage ............................................. 12 Excess Liability ................................................................................................. 12 Contractor's Pollution Liability (Including Asbestos Abatement) ...................... 13 Builders Risk ..................................................................................................... 13

Enrolled and Excluded Contractor Required Coverage .............. 15 Contractor Maintained Coverages ........................................................... 15

Automobile Liability ........................................................................................... 15 Workers’ Compensation and Employer’s Liability ............................................ 15 Commercial General Liability ............................................................................ 16 Umbrella Liability (Enrolled) .............................................................................. 16 Umbrella Liability (Excluded) ............................................................................ 16 Property Insurance ........................................................................................... 17 Watercraft and Aircraft Liability ......................................................................... 17 Pollution Liability ............................................................................................... 17 Professional Liability ......................................................................................... 18

Verification of Required Coverages ......................................................... 18 Insurance Certificates .............................................................................. 19

Contractor’s Monitoring Responsibility ............................................................. 20 Additional Insured Endorsement .............................................................. 20 Waivers of Subrogation ............................................................................ 20

Contractor Responsibilities ........................................................... 22 Contractor Bids – Excluded Insurance Costs ........................................... 23 Enrollment – Enrolled & Excluded Contractors ........................................ 23 Web Based Enrollment Instructions ......................................................... 24

Subcontractor Enrollment ................................................................................. 24 Contractor/Subcontractor Log on Setup – First time Log On ........................... 24 Enrollment Steps .............................................................................................. 26

Safety Guidelines ..................................................................................... 33 AVIATION OCIP Safety Class ................................................................. 33 Assignment of Return Premiums ............................................................. 33 Change Order Procedures ....................................................................... 33 Close-Out and Audit Procedures ............................................................. 33 Final Completion or Final Acceptance ..................................................... 33 Contract Termination/Cessation of AVIATION OCIP Coverage .............. 34

AVIATION OCIP Incident Procedures ........................................... 35 Incident/Accident Reporting ..................................................................... 35 Incidents/Accidents Procedures ............................................................... 35

T A B L E O F C O N T E N T S

METROPOLITAN WASHINGTON AIRPORTS AUTHORITY AVIATION OCIP Insurance Manual January 2016 Edition ii

Pollution Incidents/Accidents ................................................................... 36 Investigation Assistance ........................................................................... 36 Safety Obligations .................................................................................... 37

AVIATION OCIP Forms ................................................................... 38 AVIATION OCIP Form - 1GL - Enrollment Application ............................ 39 AVIATION OCIP Form - 2GL - Notice of Work Completion ..................... 42 AVIATION OCIP Form - 3GL - Pre-Enrollment ........................................ 44 AVIATION OCIP Form - 4GL – Incident Report ....................................... 45 Sample Certificate to be supplied by Enrolled Contractors ONLY ........... 47 Sample Certificate to be supplied by Excluded Contractors ONLY ......... 48

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O V E R V I E W

METROPOLITAN WASHINGTON AIRPORTS AUTHORITY AVIATION OCIP Insurance Manual January 2016 Edition 2

AVIATION OCIP does not cover Contractor’s or subcontractor’s motor vehicles used in the performance of the work, whether kept, used, or operated on or off the Job Site. Refer to Section 5 for Contractor Required Coverage.

The Authority will pay insurance premiums for the AVIATION OCIP coverage described in this manual. You should notify your insurer(s) to endorse your coverage to be excess and contingent over the AVIATION OCIP coverage provided under this AVIATION OCIP for on-site activities and the related costs. Each bidder, the Contractor and its subcontractors, is required to exclude from its bid price and requests for payment, the cost of insurance coverages that will be provided by the Authority. Enrolled Contractors must purchase their own insurance for off-site activities and exposures not covered by the AVIATION OCIP and must submit certificates of insurance as required by their contract.

Insurance coverages and limits provided under the AVIATION OCIP are limited in scope and are specific to work performed, commencing on the inception date of your enrollment into this program and limited to only work performed at the Job Site. Your insurance representative should review this information. Any additional coverage you may wish to purchase will be at your option and expense.

Discontinuation of AVIATION OCIP The Authority reserves the right to discontinue the AVIATION OCIP upon forty-five (45) calendar days notice to all Enrolled Contractors. Upon such notice, the Enrolled Contractors shall obtain and maintain at the Authority’s expense during the performance of the work, all of the AVIATION OCIP coverages specified in Section 4 (AVIATION OCIP Insurance Coverage) of this manual. Such replacement coverages shall be consistent with the form, content, limits of liability, and financial strength of insurers as had been previously provided in the AVIATION OCIP, where reasonably commercially available. The Authority will reimburse reasonable replacement costs of such coverages. Written evidence identifying the itemization of insurance costs for the replacement coverages must be provided to the Authority before reimbursement will be made. Modification of AVIATION OCIP The Authority reserves the right to modify the AVIATION OCIP policies. Any such modifications will be reflected in the renewal certificates.

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O V E R V I E W


Contracts For Terminal B/C Long-Term Redevelopment # SAFETY OBLIGATIONS

1.

General Liability Obligation. The Contractor is responsible to pay a sum of up to Fifty Thousand Dollars ($50,000) for each occurrence, including, but not limited to, investigative fees and costs, court costs, attorney’s fees and costs of defense for bodily injury or property damage to the extent losses are payable under the AVIATION OCIP General Liability Policy.

2.

Pollution Liability Obligation. The Contractor is responsible to pay a sum of up to the first Two Hundred Fifty Thousand Dollars ($250,000) for each occurrence to the extent losses are payable under the AVIATION OCIP Pollution Liability Policy.

3.

Builders Risk Obligation. The Contractor is responsible to pay a sum of up to One Hundred Thousand Dollars ($100,000) for each claim to the extent losses are payable under the AVIATION OCIP Builders Risk Policy. In the event of a tunnel collapse, the Contractor’s Builders Risk Obligation is a sum of up to One Hundred Thousand Dollars ($100,000) for each claim. The Contractor’s Builders Risk Obligation for a claim caused by or resulting from flood is a sum of up to Five Hundred Thousand Dollars ($500,000) for each claim. NOTE: The cost of damaged or stolen non-covered property will not be included in the Builders Risk Obligation calculation.

4.

Property Obligation. The Contractor is responsible to pay a sum of up to One Hundred Thousand Dollars ($100,000) for any damages to Authority property caused by the Contractor or its subcontractors.

O V E R V I E W


Contracts Awarded After 03/01/2016 (non-Terminal B/C Long-Term Redevelopment)

(excludes contracts for Terminal B/C Long-Term Redevelopment) # SAFETY OBLIGATIONS

5.

General Liability Obligation. The Contractor is responsible to pay a sum of up to Twenty Five Thousand Dollars ($25,000) for each occurrence, including, but not limited to, investigative fees and costs, court costs, attorney’s fees and costs of defense for bodily injury or property damage to the extent losses are payable under the AVIATION OCIP General Liability Policy.

6.

Pollution Liability Obligation. The Contractor is responsible to pay a sum of up to the first One Hundred Fifty Thousand Dollars ($150,000) for each occurrence to the extent losses are payable under the AVIATION OCIP Pollution Liability Policy.

7.

Builders Risk Obligation. The Contractor is responsible to pay a sum of up to Fifty Thousand Dollars ($50,000) for each claim to the extent losses are payable under the AVIATION OCIP Builders Risk Policy. In the event of a tunnel collapse, the Contractor’s Builders Risk Obligation is a sum of up to One Hundred Thousand Dollars ($100,000) for each claim. The Contractor’s Builders Risk Obligation for a claim caused by or resulting from flood is a sum of up to Two Hundred Fifty Thousand Dollars ($250,000) for each claim. NOTE: The cost of damaged or stolen non-covered property will not be included in the Builders Risk Obligation calculation.

8. Property Obligation. The Contractor is responsible to pay a sum of up to Fifty Thousand Dollars ($50,000) for any damages to Authority property caused by the Contractor or its subcontractors.

O V E R V I E W


Contracts Awarded Prior To 03/01/2016 (non-Terminal B/C Long-Term Redevelopment)

(excludes contracts for Terminal B/C Long-Term Redevelopment) # SAFETY OBLIGATIONS

9.

General Liability Obligation. The Contractor is responsible to pay a sum of up to Five Thousand Dollars ($5,000) for each occurrence, including, but not limited to, investigative fees and costs, court costs, attorney’s fees and costs of defense for bodily injury or property damage to the extent losses are payable under the AVIATION OCIP General Liability Policy.

10

Pollution Liability Obligation. The Contractor is responsible to pay a sum of up to the first Fifteen Thousand Dollars ($15,000) for each occurrence to the extent losses are payable under the AVIATION OCIP Pollution Liability Policy.

11

Builders Risk Obligation. The Contractor is responsible to pay a sum of up to Five Thousand Dollars ($5,000) for each claim to the extent losses are payable under the AVIATION OCIP Builders Risk Policy. In the event of a tunnel collapse, the Contractor’s Builders Risk Obligation is a sum of up to One Hundred Thousand Dollars ($100,000) for each claim. The Contractor’s Builders Risk Obligation for a claim caused by or resulting from flood is a sum of up to Twenty Five Thousand Dollars ($25,000) for each claim. NOTE: The cost of damaged or stolen non-covered property will not be included in the Builders Risk Obligation calculation.

12Property Obligation. The Contractor is responsible to pay a sum of up to Five Thousand Dollars ($5,000) for any damages to Authority property caused by the Contractor or its subcontractors.

O C I P D I R E C T O R Y


AVIATION OCIP Directory Insurance Administrator Wells Fargo Insurance Services, Inc. (WFIS) 1750 H Street, Suite 200 Washington, DC 20006

Metropolitan Washington Airports Authority 1 Aviation Circle MA-570, Suite 188 Washington, DC 20001-6000

AVIATION OCIP Safety Consultant Gerry Boudreau, WFIS Assistant Vice President

(703) 760-5711 (telephone) (571) 437-0735 (cell) (877) 827-0725 (fax) [email protected] (E-Mail)

AVIATION OCIP Administrator Maxwell Asante, WFIS Account Representative

(202) 416-2538 (telephone) (877) 827-0725 (fax) [email protected] (E-Mail)

WFIS AVIATION OCIP Client Executives Christopher Spiridis and Jamie L. Pincus

(917) 368-6804 (telephone) (212) 973-9809 (fax) (347) 501-1047 (cell) [email protected] (E-Mail) (202) 416-2502 (telephone) (877) 827-0725 (fax) (202) 754-0408 (cell) [email protected] (E-Mail)

WFIS AVIATION OCIP Account Manager Nick Morgan, WFIS Program Administrator

(202) 416-2544 (telephone) (202) 815-4303 (cell) (877) 827-0725 (fax) [email protected] (E-Mail)

WFIS Claims Consultant Andy Tse


Airports Authority Claims Program Manager

Tara Dahbi

(703) 417-8654 (telephone) (703) 417-0882 (fax) (703) 209-5303 (cell) [email protected] (E-Mail)

Airports Authority Manager, Risk Management Department

Frank J. Wojnar, Jr. ACE


Section

2

O C I P D E F I N I T I O N S


AVIATION OCIP Definitions TERM DEFINITION

Airports “Airports” refers to either Ronald Reagan Washington National Airport or Washington Dulles International Airport or collectively both.

Airports Authority Claims Program Manager

The Authority employee responsible for processing all claim reports and coordination of all claim-related communication.

Airports Authority Manager, Risk

Management Department

The Authority employee responsible for the overall administration of claims, safety and insurance programs.

AVIATION OCIP “Owner Controlled Insurance Program” - A coordinated insurance program providing certain coverages, as defined herein, for the Authority, Eligible and Enrolled Construction Manager, Contractors, and subcontractors performing Work at the Job Site.

AVIATION OCIP Administrator

The representative of the Risk Management Department who administers enrollments for the AVIATION OCIP.

AVIATION OCIP Safety Consultant

All incidents, injuries, occupational-related illnesses, or property damage are to be reported within 24 hours to this representative of the Risk Management Department. This Consultant advises and provides safety related recommendations to the Authority and enrolled Contractors performing work at the Airports and/or Toll Road. Advises Job Site personnel of safety training and compliance issues to control losses and assists in the processing of AVIATION OCIP claims.

Contractor A Contractor is a party that holds a contract with the Authority.

Eligible Parties Parties performing labor or services at the Job Site are eligible to enroll in the AVIATION OCIP unless an Excluded Party.

Enrolled Parties also called: Enrolled Contractors Enrolled Subcontractors

Those eligible Contractors and their Subcontractors and their Sub-subcontractors (all may also be referred to as Enrolled Parties) that have submitted all necessary enrollment information and have been accepted into the AVIATION OCIP as evidenced by receipt of a confirmation letter and certificate of insurance. Enrolled Parties shall obtain and maintain, and shall require each of its subcontractors to obtain and maintain, the insurance coverage specified in Section 5 of the AVIATION OCIP Manual.

Section

3



TERM DEFINITION Excluded Parties also called: Excluded Contractors Excluded Subcontractors

Certain work is excluded from the AVIATION OCIP. Excluded Parties shall obtain and maintain, and shall require each of its subcontractors to obtain and maintain the insurance coverage specified in Section 5 of the AVIATION OCIP Manual. The following Excluded Parties are ineligible for AVIATION OCIP Coverages: (1) Professional services of architects, engineers, surveyors, and

consultants (this exclusion does not apply to AVIATION OCIP Contractor’s Pollution Liability for contracting activities at the Job Site).

(2) No coverage will be provided for any work performed by any Contractor engaged in the abatement of asbestos, asbestos products, asbestos-containing materials or products, including manufacturing, mining, use, sale, installation/removal or distribution activities (this exclusion does not apply to AVIATION OCIP Contractor’s Pollution Liability).

(3) Work performed off Authority property or at another location not specifically included in the definition of the Job Site.

(4) Vendors, suppliers, fabricators, material dealers, truckers, haulers, drivers and others who merely transport, pick up, deliver, or carry Equipment and/or Materials, construction equipment and supplies, materials, personnel, parts or equipment or any other items or persons to or from the Job Site.

(5) Any Persons and/or Entities who do not perform labor or services at the Job Site.

(6) Contractors performing work for tenants, or if enrolled, no coverage is provided for the Contractor when performing work for a tenant.

The Authority may include or exclude any parties or entities not specifically identified in this manual at its sole discretion, even if otherwise eligible.

Insurance Administrator Wells Fargo Insurance Services USA, Inc. 1750 H St, NW Suite 200 Washington, DC 20006

Job Site

Generally, the sites of contract work on the Authority’s property at Ronald Reagan Washington National Airport, Washington Dulles International Airport, or Dulles Toll Road. For a more precise definition of the Job Site refer to the contract.

Program Management Support Services Consultant

The consultant employed by the Authority under contractual agreement to provide program management support services for construction projects at the Airports and the Toll Road, including planning, design, construction and related services



TERM DEFINITION Subcontractor A subcontractor is a party that holds a contract with a Contractor.

Sub-subcontractor A sub-subcontractor is a party that holds a contract with a subcontractor of any tier.

Toll Road Refers to the Dulles Toll Road which is operated by the Authority for financing the construction of the Dulles Corridor Metrorail Project using Toll Road revenue to support the sale of bonds.

O C I P I N S U R A N C E C O V E R A G E


AVIATION OCIP Insurance Coverage This chapter provides a brief description of AVIATION OCIP Coverage. Contractor should refer to the actual policies for details concerning coverage, exclusions and limitations.

Enrolled Parties Enrolled Parties must meet the insurance requirements established in Section 5 and must provide evidence of coverage to the Authority’s AVIATION OCIP Administrator or the Insurance Administrator before beginning any work at the Job Site.

Excluded Parties Excluded Parties must meet the insurance requirements established in Section 5 and must provide evidence of coverage to the Authority’s AVIATION OCIP Administrator or the Insurance Administrator before beginning any work at the Job Site.

Evidence of Coverage The AVIATION OCIP Administrator will provide a Certificate of Insurance evidencing general liability, excess liability insurance, and Builder’s Risk coverage to each Enrolled Party. Copies of AVIATION OCIP insurance policies will be available upon written request to the Authority’s Manager, Risk Management Department.

The summary descriptions on these pages are not intended to be complete or to alter or amend any provision of the actual AVIATION OCIP Coverages. In the event any provision of the summary below conflicts with the AVIATION OCIP insurance policies, the provision of the actual AVIATION OCIP insurance policies shall govern. This is a summary of insurance coverages ONLY. All Enrolled Parties, Enrolled Contractors and Enrolled Subcontractors should refer to the AVIATION OCIP insurance policies for actual terms, conditions, exclusions and limitations.

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ides, but is erage, subjeregate for eregate for flomissions direct physver is less, sexceed $25roperty wh

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January 2016 E

not limited ect to sublimearthquake ood

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January 2016 E

and off site

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pplies to bding explo

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16

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n the policy perty

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T O R R E Q U

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January 2016 E

xcess of $1mits will be s

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TION OCEmployers erlying policequirementsager, RiskacknowledgManageme

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r due to chally apply. pplies to bding explo

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17

–

Liability 0,000 0,000 0,000

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Contract.

Limits of liParties invo

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iability for olved in aba

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ting hazarMCS-90 E

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gregate

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n managerand other

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AVIATION O3) days of ample of a(Forms). P

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January 2016 E

on Liability

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Please note actors’ reqution and adact. The C

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y Insurance

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the Job and supplieof liability.

with an anned:

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with an anned:

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owing limits

Limits of L$ 25,000$ 25,000

eyors, planide Professperiod prov

ors shall pronistrator priwal, changble certifica

that all Enruired insurdditional insContractor

18

e for

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Insu ContraCompeEmploGenerAutomUmbreLiabilitinsureWaiveSubrogthe Airand otParties ContraAutomGenerExcessLiabilitname Authoremployand ansubsidorganiadditioand wicoveraon a pcontrib See Sefor samof insu

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actor’s Workensation &

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mobile Liabilitella /Excess ty and Propers shall provrs of gation in favrports Authoher designas.

actor’s mobile Liabilitral Liability as/Umbrella ty Policies wthe Airports rity, its officiayees and agny wholly owdiaries or parzations as

onal insuredsill state that age is affordrimary and n

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ection 8 (Fomple certificaurance.

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provide the Acancellation

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Authority ad, material ch

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must be issonwealth ont and finano AM Best’sued by Lloyto the Comty), or of rehe parties an

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or replaceme

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V E R A G E

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ten notice oolicy terms o

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don and apof Virginiafinancial red in writing

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January 2016 E

of at least 30or coverage

required of re minimumsed on the

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o do businent policyholess than “AGuide (excepreign compaved in writiny and otherhority.

after SubstaIP site workovide the tAny excep

partment.

subcontraccontract and

cies requireits autho

lid and prouired for EnrVIATION Ohree (3) day

rance comshed by the

tten notice n policy term

19

ase of al.

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C O N T R A C T O R R E Q U I R E D C O V E R A G E


Contractor’s Automobile Liability, General Liability and Excess/Umbrella Liability Policies must name the Authority, its officials, employees and agents and any wholly owned subsidiaries or parent organizations as additional insureds and must state that coverage is afforded on a primary and non-contributory basis.

The Contracting Officer, Contracting Officer’s Technical Representative, Risk Management Department staff, and AVIATION OCIP Safety Consultant have the right to stop work or prevent any non-enrolled Contractor or subcontractor of any tier from entering the Job Site until the Contractor's evidence of insurance has been filed. Denial of site access for this reason will not be accepted as the basis for a delay claim. Contractor’s Monitoring Responsibility Subcontractors are obligated to maintain coverage as required by contract, and are required to submit evidence of coverage to the AVIATION OCIP Administrator. Contractors are responsible for monitoring their Enrolled subcontractors’ and Excluded subcontractor’s certificates of insurance. Copies of all its subcontractors’ certificates of insurance should be maintained by the Contractor, and upon request, be supplied to the Authority or its authorized representatives. Copies of Contractor or subcontractor insurance policies required by contract should be supplied to the Authority or its authorized representatives upon request. All subcontractors, whether considered Enrolled or Excluded, must submit their certificates of insurance via the web portal. Additional Insured Endorsement Each policy, except Workers Compensation and Professional Liability, shall name the Metropolitan Washington Airports Authority, their respective officers, agents and employees as additional insureds. The additional insured endorsement shall state that the coverage provide thte additional insureds is primary and non-contributing with repect to any other insurance available to the additional insureds. Waivers of Subrogation All Contractors and subcontractors of any tier agree to waive all rights of subrogation against each other and the Authority, its officers, agents, employees and any of its insurers regarding any insured loss, whether the insurance is provided by the AVIATION OCIP or purchased by the Contractor for the project. Contractors and subcontractors of any tier must agree that this waiver applies to its insurers, including any insurance policies covering physical loss or damage to owned, non-owned, or leased machinery, watercraft,

C O N T R A C T O R R E Q U I R E D C O V E R A G E


vehicles, tools, or equipment. The Authority shall waive all rights of subrogation against the Enrolled Contractors and subcontractors of any tier as respects any insured loss covered under the AVIATION OCIP.

C O N T R A C T O R R E S P O N S I B I L I T I E S


Contractor Responsibilities Throughout the course of the Project, Contractors and subcontractors will be responsible for reporting and maintaining certain records as outlined in this section.

he Contractor and its subcontractors of all tiers are required to cooperate with the Authority and its AVIATION OCIP Administrator and the Insurance Administrator in all aspects of AVIATION OCIP

operation and administration. The responsibilities include, but are not limited to:

Complying with the provisions of the AVIATION OCIP Manual and cooperating in the administration and operation of the AVIATION OCIP

Identifying and removing from your bid the cost of AVIATION OCIP-provided insurance

Providing each subcontractor with a copy of the AVIATION OCIP Insurance Manual and the Authority Construction Safety Manual

Enrolling in the AVIATION OCIP through the web based portal and ensuring all subcontractors promptly enroll in the AVIATION OCIP through the web based portal prior to the start of any work

Including AVIATION OCIP provisions in all subcontracts as appropriate

Providing timely evidence of insurance to the AVIATION OCIP Administrator

Notifying the AVIATION OCIP Administrator of all subcontracts awarded

Cooperating with the AVIATION OCIP Administrator and Insurance Administrator’s requests for information

Complying with insurance, claim and safety procedures Prompting payment of Safety Obligations as required by the

Contract Reporting claims promptly and cooperating with all follow-up

requests

Section

6T

SeeAVform

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Notifyinginsurancinsuranc

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not automac. Eligiblerms and papply separail enrollmen

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January 2016 E

ator immedof Contra

on Safety Mequirements

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d their subct enroll in ntractors m are awarde

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23

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Step 2: User information must be confirmed. Verify and correct information or input information if any is missing and then click the Continue button.

Step 3: Confirm Physical Address. Verify and correct information

or input information if any is missing and then click the Continue button.

Step 4: Setup Complete screen appears. Click Finish button and

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Enrollment Steps 1. Sign into the AVIATION OCIP Portal with the username and

password that was provided via email from the AVIATION OCIP Administrator. The Project Home page appears once logged in.

2. Click Contractor Packages in the left side menu. 3. The Contractor Package Management page displays.

• The list of displayed Contractor Packages can be filtered using the Project, Work Site, and Trade dropdown lists.

• Click the Select link in the last column of the grid for the Contractor Package to be edited.

NOTE: The Status section provides the status of the individual contractor’s enrollment in the process.

4. After clicking on Select, the Contractor Package Action page will appear.

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Safety Guidelines Each Contractor is required to establish a written safety program and to provide a designated safety representative who is on site when ANY work is in progress. Minimum standards for Contractor programs are outlined in the Authority’s Construction Safety Manual. AVIATION OCIP Safety Class Enrolled Contractors are required to send all full-time and part-time safety personnel, along with any other on-site employees responsible for safety, to any AVIATION OCIP Safety classes as scheduled. It is the responsibility of the Contractor’s safety personnel attending the AVIATION OCIP Safety classes to train ALL Contractor and subcontractor employees working on the Authority’s projects. Assignment of Return Premiums The Authority pays the cost of the AVIATION OCIP insurance coverage. The Authority will be the sole recipient of any return AVIATION OCIP premiums or dividends. All Enrolled Parties will assign, to the Authority, all adjustments, refunds, premium discounts, dividends, costs or any other monies due from the AVIATION OCIP insurer(s). Enrolled Contractors will ensure that each Enrolled Subcontractor has executed such an assignment. The Enrollment Application form (AVIATION OCIP Form - 1GL) supplied in Section 8 will be used for this purpose. Change Order Procedures Change orders will be priced, by the Contractor and its subcontractors, to exclude their cost of AVIATION OCIP-provided insurances.

Close-Out and Audit Procedures When a Contractor and/or an associated subcontractor has completed its Work at the Job Site and no longer has on-site workers, it must submit the Notice of Work Completion form (AVIATION OCIP Form - 2GL). A copy of the Notice of Work Completion form, (AVIATION OCIP Form - 2GL) with instructions on the proper method for completion, is found in Section 8.

The Authority will not release final payment until all necessary forms have been submitted to the AVIATION OCIP Administrator and/or Insurance Administrator. The Contractor is responsible for any missing documentation of its subcontractors.

Final Completion or Final Acceptance The Contracting Officer (CO) will provide to the AVIATION OCIP Administrator an acknowledgement of Final Completion or Final Acceptance of the contract or project.



Contract Termination/Cessation of AVIATION OCIP Coverage In the event a contract is terminated for any reason by the Authority, coverage under the AVIATION OCIP ceases at the date and time the contract is terminated unless otherwise agreed to by the Authority’s Manager, Risk Management Department or his authorized representative in writing.

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A V I A T I O N O C I P F O R M S


AVIATION OCIP Forms This section contains the following forms:

AVIATION OCIP Form - 1GL Enrollment Application AVIATION OCIP Form - 2GL Notice of Work Completion AVIATION OCIP Form - 3GL Pre-Enrollment AVIATION OCIP Form - 4GL Incident Report Exhibit 1 Enrolled Sample Certificate of Insurance Exhibit 2 Excluded Sample Certificate of Insurance

Note For assistance in completing these forms, please contact:

Maxwell Asante, OCIP Administrator Wells Fargo Insurance Services

Phone 202-416-2538

or

Nick Morgan, OCIP Account Manager Wells Fargo Insurance Services

Phone 202-416-2544

Section

8



AVIATION OCIP Form - 1GL - Enrollment Application Metropolitan Washington

Airports Authority Page 1 of 3

*** NOTICE *** Enrollment is not automatic and requires the satisfactory completion of the AVIATION OCIP Form - 1GL. Examine your current General Liability Policies or contact your Insurance Agent to assist you with completing this form. In addition, submit a Certificate of Insurance providing evidence of your on-site and off-site coverages. Please refer to the Insurance Manual for coverage requirements. See page 3 of this form for instructions

A. CONTRACTOR INFORMATION: 1. Federal ID # or Soc. Sec. #

2. u Business Information (headquarters) 3. u Contact Information (address questions to...)

Company Name & dba Contact Name & Title

Address

City, State Zip Code

Telephone

Fax

Email Address

1. Your Organization’s Structure Corporation Joint Venture

Partnership Sole Proprietor

S-Corporation Other _____________________________

LDBE Status Yes No

B. CONTRACT INFORMATION: 1. Contract #

2. Work (Job Site) Location Dulles International Airport Reagan National Airport Dulles Toll Road

3. Date Contract Awarded

4. Description of Work

5. Proposed Contract Price $ 5a. Are you Submitting a bid to the Authority? Yes No

6. Amount of Self Performed Work $ 5b. If No, identify who with.

7. Start Date Actual Estimated 8. Completion Date Actual

Estimated

C. CONTACTS: Position Name & Title Phone Fax Email Address

1. Project Manager

2. Safety Rep

3. Insurance/Risk Mgmt

4. Claims

5. MWAA COTR

6. MWAA CO

D. PROVIDE YOUR CURRENT WORKERS COMPENSATION INFORMATION: (for each state you will perform work in)

1. Applicable State 2. Risk ID Number 3. Rating Bureau 4. Anniversary Rating Date

5. Your WC Insurance Carrier

6. Policy #: 7. Effective Date: 8. Expiration Date:



AVIATION OCIP Form - 1GL - Enrollment Application Metropolitan Washington


E. SUBCONTRACT INFORMATION: Provide information on all Subcontractors that will be working for you on this project. Please use additional paper, if necessary.

1. Subcontractor

Name 2.

Mailing Address 3.

Trade & NAICS

4. Estimated Value of

Subcontract

5. Contact Person

(Project Manager)

6. Phone, Fax, Email

7. Estimated Start Date

$

$

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$

F. ENROLLMENT QUESTIONS: Answer each question. Use additional paper if necessary.

1. Will you have any off-site location(s) 100% dedicated to this project?

Yes No If yes, please provide address:

2. Please check if: Any aircraft used on this project Any watercraft used on this project

3. Please indicate if labor from the following sources will be used: Employee Leasing Firm Temporary Labor Agency

4. What is your Virginia Contractor’s License Number?

5. What is your License Class A, B or C?

G. WARRANTY APPLICABLE TO PROGRAM INSURANCE COVERAGE

Premiums for this Program are the responsibility of the Metropolitan Washington Airports Authority and I agree that any and all return of premium, dividends, discounts, or other adjustments to any Program policy(ies) is assigned, transferred, and set over absolutely to the Metropolitan Washington Airports Authority. This assignment applies to the Program policy(ies) as now written or as subsequently modified, rewritten, or replaced. Rights of Cancellation for all Program insurance policy(ies) arranged by the Metropolitan Washington Airports Authority are assigned to the Metropolitan Washington Airports Authority. 1. I will pay the cost of premium(s) for non-AVIATION OCIP Program insurance coverage, specified in the Contract Documents. 2. I authorized the release of all claim information for all insurance policies under the AVIATION OCIP. 3. It is my responsibility to notify my insurance carrier(s) that I am enrolling in the AVIATION OCIP. 4. I have omitted from my bid the insurance costs for the coverage provided by Metropolitan Washington Airports Authority.

5. The statements in this insurance application are true to the best of my knowledge.

H. Signature Block : I verify the information presented above and attachments are correct:

Print Name Date

Title Signature

Email to: Maxwell Asante, OCIP Administrator Phone: 202-416-2538 Wells Fargo Insurance Services, Inc. 1750 H Street, NW Suite 200 Fax: 877-827-0725 Washington DC 20006 Email: [email protected]



AVIATION OCIP Form - 1GL - Enrollment ApplicationINSTRUCTIONS

Metropolitan Washington Airports Authority

Page 3 of 3This form must be completed and submitted by each successful Contractor and Subcontractor of any tier prior to Job Site mobilization for each contract awarded. The Contractor and Subcontractor will submit the completed form to Wells Fargo Insurance Services (WFIS). Upon receipt of this form, WFIS will issue to the Contractor or Subcontractor a Certificate of Insurance evidencing coverage in the AVIATION OCIP. The completed Certificate of Insurance will be mailed to the Enrolled party.

A. Contractor Information 1 Enter your company’s Federal ID number. This number can be found on filings made to the federal government such as your tax return. 2 Enter your company’s business information including name, mailing address, phone/fax number, and email address for your company’s primary office location. 3 Enter the name of the person Wells Fargo should contact if questions arise. Include mailing address, phone/fax and email address, if different than A2.

4 Identify your company’s legal structure and LDBE Status by checking the boxes that apply. If the correct legal structure is not specifically listed, please check the “Other” box and specify in the space provided.

B. Contract Information 1 Enter the Contract Number or Purchase Order Number that was included in the Metropolitan Washington Airports Authority’s originating documentation. 2 Check the Job Site Location. 3 Enter the Date the Contract was awarded to your organization. 4 Provide a brief description of the work you will be performing at the project site. 5 Identify the total dollar amount of your contract. 5a Check the appropriate box that identifies if you contract directly with Metropolitan Washington Airports Authority or are a Subcontractor. 5b If you are a Subcontractor, identify the entity with who you are under contract. 6 Identify the amount of work that you anticipate will be self-performed. 7 Enter the Date you anticipate starting work and then mark whether the date provided is actual or estimated. 8 Enter the Date you anticipate completing the described work and then mark whether the date provided is actual or estimated. C. Contacts (Requested Contact information is for specific functions. It is possible to have a single person fulfill multiple responsibilities. These individuals should be located, if at all possible, on-site.) 1 Identify your Project Manager for this Contract. 2 Identify your Safety Representative for this Contract. 3 Identify your Insurance/Risk Management Representative for this Contract. 4 Identify your Claims Representative for this Contract. 5 If applicable, identify the Metropolitan Washington Airports Authority Contracting Officer Technical Representative for your Contract. 6 If applicable, identify the Metropolitan Washington Airports Authority Contracting Officer for your Contract. D. Current on-site and off-site Workers Compensation Information (Information relates to your corporation’s existing coverage; identify each modification factor that applies.) 1 Enter the State that the Modification Information applies to. 2 Enter your Bureau File Number also referred to as your Risk Identification Number. This number can also be found on your Modification worksheets. 3 Enter the Bureau Rating Agency. In most states this is NCCI. 4 Provide your Company’s Anniversary Rating Date. Information can be located on your bureau’s WC Experience Modification worksheets. 5 Identify your insurance carrier for Workers Compensation coverage. 6 Provide your Workers Compensation Policy Number. 7 Provide the effective date of your Workers Compensation policy. 8 Provide the expiration date of your Workers Compensation policy. E. Subcontractor Information (Provide the following information for each Subcontractor that will be performing work at the project site. Use additional sheets, if necessary.) 1 Identify the name of the Subcontracting firm. 2 Provide the mailing address for the Subcontractor. 3 Provide the Trade name and NAICS for the Subcontractor. 4 Provide the estimated value of the subcontracted activity. 5 Provide a contact name, preferably the project manager, for the Subcontractor. 6 Provide the phone number, fax number, and email address for the Subcontractor. 7 Provide the date the Subcontractor is scheduled to begin work. F. Enrollment Questions

1 Determine if you will have any locations, off-site, that will be 100% dedicated to this project. Include material/supply storage as a possible location. Mark the appropriate box (yes/no). If you answer yes – provide the address of each location you identified as 100% dedicated.

2 Mark the boxes that apply. Contemplate only work performed under this contract.

3 Mark the boxes that apply. Employee Leasing Firm are those firms that supply the labor force for your company (You direct the activities of the Leasing Company’s employees). Temporary Labor Firms supplement your labor force.

4 Enter your Virginia Contractor’s License Number. 5 Enter whether your Virginia Contractor’s License is Class A, B, or C. G. Warranty Statements: 1-6 Read each Warranty statement thoroughly. If you have questions regarding any of these statements, contact the AVIATION OCIP Administrator identified on

page 2. H. Signature Block: This form must be signed by a representative of your company knowledgeable of its accuracy.



AVIATION OCIP Form - 2GL - Notice of Work Completion Metropolitan Washington


A. General Information

1. Contractor

2. Under Contract with

3. Contract #

4. Description of Work Performed

5. Date Work Completed

6. Date this Contract Completed

7. Final Contract Value $

B. Work Completion The following Subcontractors have completed their Work at the Job Site: (Add attachment if more space is needed)

1. Subcontractor’s Name

2. Contract Number

3. Description of Work

4. Date Completed

C. Signature Block

The undersigned acknowledges request for termination of Coverage under the AVIATION OCIP as of the date indicated above for the specified Contract. Should we return to the work Site, we will be working under our own insurance program and must provide Metropolitan Washington Airports Authority with a Certificate of Insurance showing our own Coverage as detailed in our contract. 1. Contractor’s Representative’s Signature

Print Name Date

Title Signature

2. Prime Contractor’s Representative’s Signature

Print Name Date

Title Signature

Maxwell Asante, OCIP Administrator Phone: 202-416-2538 Email to: Wells Fargo Insurance Services, Inc. 1750 H St, NW Suite 200 Fax: 877-827-0725 Washington, DC 20006 Email: [email protected]



AVIATION OCIP Form - 2GL - Notice of Work Completion INSTRUCTIONS

Metropolitan Washington Airports Authority

Page 2 of 2This form must be completed and returned to the AVIATION OCIP Administrator by the Contractor or Subcontractor whenever work is completed for each Contract or Subcontract.

A. General Information 1 Provide the name of the Contractor completing their work. 2 Provide the name of the Entity this Contractor has a contract with. 3 Enter the contract number for the work being completed. 4 Provide a brief description of the work being completed. 5 Provide the Date the Work was completed. 6 Provide the Date the Contract was completed, if other than the work completion date. 7 Provide the Final Contract Value.

B. Work Completion 1 Enter the name of each Subcontractor that performed work for you that has also completed their work. 2 Enter Subcontractors Contract Number. 3 Provide a brief description of their work. 4 Provide the Date they completed their work.

C. Signature Block 1 This form must be signed by a representative of your company with the Authority to Verify that the information is correct. 2 Have this form approved by the Prime Contractor for the Project Site.

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AVIATION OCIP Form - 4GL – Incident Report





Sample Certificate to be supplied by Enrolled Contractors ONLY CERTIFICATE OF LIABILITY INSURANCE



Sample Certificate to be supplied by Excluded Contractors ONLY CERTIFICATE OF LIABILITY INSURANCE