Valley Stream, NY · Nassau County
Insurance and Indemnification Requirements for Independent Contractors and Subcontractors
This agreement sets out insurance and indemnification requirements for independent contractors and subcontractors working for the Incorporated Village of Valley Stream.
What this form is
The document describes insurance coverage, minimum limits, certificates, and additional-insured requirements for independent contractors and subcontractors. It also includes an indemnification and hold harmless agreement with spaces for the contractor or vendor and a witness to sign, date, and provide contact details. The text does not specify when or where to submit the completed agreement.
Who needs it
Independent contractors and subcontractors providing work or services for the Incorporated Village of Valley Stream need to review these requirements and complete the agreement.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details.
About notarization
This document is signed without a notary; the contractor or vendor and a witness sign and date the agreement.
How to submit this form
- 1
Download The Agreement
Download the contractor insurance and indemnification agreement PDF.
- 2
Review And Complete The Agreement
Review the insurance requirements and fill in the contractor or vendor details and signature fields.
- 3
Gather Insurance Documents
Prepare the insurance certificates and endorsements described in the document.
- 4
Submit To The Village
Submit the completed agreement to the city department named on the form; check the city website for current contact details.
Frequently asked questions
- Who uses the contractor insurance and indemnification agreement?
- Independent contractors and subcontractors working for the Incorporated Village of Valley Stream use it to review insurance requirements and sign the indemnification agreement.
- What information and signatures does the agreement request?
- The agreement includes spaces for the contractor or vendor’s signature, address, date, printed name and title, along with a witness signature.
- Do I need a notary for the contractor insurance and indemnification agreement?
- No. This document is signed without a notary; the contractor or vendor and a witness sign and date the agreement.
- How do I submit the contractor insurance and indemnification agreement?
- The document does not give submission instructions. Submit it to the city department named on the form; check the city website for current contact details.
Need something notarized?
This Insurance and Indemnification Requirements for Independent Contractors and Subcontractors doesn’t need a notary — but if you have another Valley Stream form that does, a commissioned online notary can help.