Room Rental Detailed Application

Third party liability insurance naming the Corporation of the City of Brockville as an additional insured is required for all events. Please select from one of the two options below:

Option 1 - Companies/Organizations: Certificate of Insurance
Please provide your insurance provider with the City of Brockville’s standard insurance requirement information which is listed below:
Commercial General Liability Insurance issued on an occurrence basis for an amount of not less than $5 million per occurrence / $5 million annual aggregate for any negligent acts or omissions relating to their activities/ event.
Such insurance shall include, but is not limited to, bodily injury and property damage including loss of use; personal injury; contractual liability; premises, property & operations; non-owned automobile; broad form property damage; occurrence property damage; products; broad form completed operations; employees and volunteers as Additional Insured(s); tenants’ legal liability; cross liability and severability of interest clause. Where applicable, the City will also require owners & contractors protective and/or contingent employers’ liability extensions.
If applicable, the Commercial General liability insurance policy shall not contain an exclusion pertaining to liquor liability.
Such insurance shall add the Corporation of the City of Brockville as Additional Insured subject to a waiver of subrogation with respect to the operations of the renter. This insurance shall be non-contributing with and apply as primary and not as excess of any insurance available to the City.
All deductibles applicable to the above noted insurance shall be the sole responsibility of the Named Insured and the City shall bear no cost towards such deductible.
The Named Insured is responsible to keep their property/assets insured – failure to do so shall not impose any liability on the City.
The Named Insured shall provide The Corporation of the City of Brockville with a certificate of insurance evidencing coverage as noted above. Such policies shall not be cancelled, changed or lapsed unless the Insurer notifies the City in writing at least thirty (30) days prior to the effective date of such cancellation, material change or lapse. The insurance policy will be in a form and with a company licensed to write business in the Province of Ontario and which are, in all respects, acceptable to the City.
The City also reserves the right to request additional insurance and/or higher limits of insurance or otherwise alter the types of insurance coverage requirements as the City may reasonably require from time to time.

Option 2 - Individuals/Private Users: Third Party Insurance Program
The Corporation of the City of Brockville coordinates a Third Party Insurance Program for low-risk users of municipal facilities. The policy covers any individual or community group renting a municipal facility to run an event or activity. This Program is in place for the everyday resident who would not otherwise have insurance in place as requested above. This coverage cannot be used for corporate entities or in addition to other policies of the renter. This coverage automatically adds the municipality as additionally insured on the policy. This program is a low-cost solution to protect residents of the community and provide coverage for the person in control of the event. Renters that do not have Third Party Liability Insurance as listed above will be charged the appropriate fees based the size and risk level of their event, under this program. Upon application acceptance, a sales summary clearly indicating the charge will be provided. Upon payment, a Memorandum of Insurance will be provided to the renter as proof of insurance.