Common use of Statutory Compensation Coverage Clause in Contracts

Statutory Compensation Coverage. Except as provided below, Contractor must provide Workers’ Compensation insurance for all its employees and, in case any work is subcontracted, Contractor will require the subcontractor to provide Workers’ Compensation insurance in accordance with the statutory requirements of the State, including Coverage B, Employer’s Liability. Insurance minimum limits are as follows: $100,000 – Bodily Injury by Disease per employee $500,000 – Bodily Injury by Disease aggregate $100,000 – Bodily Injury by Accident If Minn. Stat. § 176.041 exempts Contractor from Workers’ Compensation insurance or if the Contractor has no employees in the State, Contractor must provide a written statement, signed by an authorized representative, indicating the qualifying exemption that excludes Contractor from the Minnesota Workers’ Compensation requirements. If during the course of the contract the Contractor becomes eligible for Workers’ Compensation, the Contractor must comply with the Workers’ Compensation Insurance requirements herein and provide the State with a certificate of insurance. Privacy Liability Insurance (or equivalent). The coverage may be endorsed on another form of liability coverage or written on a standalone policy. The Contractor shall maintain insurance to cover claims which may arise from failure of the Contractor to ensure the security of not public data stored on the State’s documents, including but not limited to paper, microfilms, microfiche, magnetic computer tapes, cassette tapes, photographic negatives, photos, hard disks, floppy disks, and carbon sheets, while in the Contractor’s care, custody, and control. Insurance minimum limits are as follows: $2,000,000 - Per Occurrence $2,000,000 - Annual Aggregate The following coverage shall be included: State of Minnesota named as an Additional Insured unless the coverage is written under a Professional Liability policy. Exhibit C: Specifications, Duties, and Scope of Work

Statutory Compensation Coverage. Except as provided below, Contractor must provide Workers’ Compensation insurance for all its employees and, in case any work is subcontracted, Contractor will require the subcontractor to provide Workers’ Compensation insurance in accordance with the statutory requirements of the State, including Coverage B, Employer’s Liability. Insurance minimum limits are as follows: $100,000 – Bodily Injury by Disease per employee $500,000 – Bodily Injury by Disease aggregate $100,000 – Bodily Injury by Accident If Minn. Stat. § 176.041 exempts Contractor from Workers’ Compensation insurance or if the Contractor has no employees in the State, Contractor must provide a written statement, signed by an authorized representative, indicating the qualifying exemption that excludes Contractor from the Minnesota Workers’ Compensation requirements. If during the course of the contract the Contractor becomes eligible for Workers’ Compensation, the Contractor must comply with the Workers’ Compensation Insurance requirements herein and provide the State with a certificate of insurance. Privacy Liability Insurance (or equivalent). The coverage may be endorsed on another form of liability coverage or written on a standalone policy. The Contractor shall maintain insurance to cover claims which may arise from failure of the Contractor to ensure the security of not public data stored on the State’s documents, including but not limited to paper, microfilms, microfiche, magnetic computer tapes, cassette tapes, photographic negatives, photos, hard disks, floppy disks, and carbon sheets, while in the Contractor’s care, custody, and control. Insurance minimum limits are as follows: $2,000,000 - Per Occurrence $2,000,000 - Annual Aggregate The following coverage shall be included: State of Minnesota named as an Additional Insured unless the coverage is written under a Professional Liability policy. Exhibit C: Specifications, Duties, and Scope of WorkWork Furnish and install EditShare ARK System, and new EditShare VBoxHD 4 Channel for MnDOT Video Services, and provide associated product support services as specified. No substitutions for the specified EditShare products will be accepted or considered. Furnish and install EditShare ARK System Furnish and install the following EditShare ARK System products to replace the existing EditShare ARK system. Installation includes all labor, engineering, on-site commissioning, travel expenses, products, equipment, tools, and materials to fully install the specified EditShare products.  EditShare Ark System o Ark Disk Director o Ark Disk Expansion o Ark Tape Gateway  Compatible with EditShare’s tape libraries and with LTO tape libraries from manufacturers including, but not limited to, HP, Quantum, and SpectraLogic.  Facilitates creation of any number of “Tape Pools.”  Copy or migrate media and related files from “online” to “offline storage.  Verify backed up data.  Receive notifications when transfers are completed.  24 slots and one (1) LTO-7 SAS drive installed.  Includes Ark Master software and 24 Ark Tape license.  Ark SAS Connection Kit.  Includes SAS HBA and 1m SAS cable.  Ark Small Tape Library Platform perpetual license.  Unlocks Ark platform for 24 slot tape libraries. o Server Hardware  Intel Quad Core Xeon CPU, Intel chipset  12GB XXX0-0000 XXx XXX highspeed RAM  Mirrored 2.5" 320GB SATA 3 Gb/s OS drives, rear accessible  6Gb/s Hardware RAID Controllers with SATA/SAS ports  3.5" enterprise-class 7200rpm SATA or SAS 6Gb/s media drives in 1TB, 2TB, or 4TB capacities (16 per Ark Disk Director or Expansion Chassis, 4 per Ark Tape Gateway)  RAID 6 as standard, configurable to other RAID standards such as RAID 5 o Warranty  Five (5) year warranty covering all products specified in this. o Annual Support  Provide one year of 24 hour telephone, portal, and email support, which also covers Software and includes full version software upgrades. Furnish and install Editshare VBOX multichannel distributed video server. Furnish and install EditShare VBOX In/Out 4 Channel HD multichannel distributed video server to replace existing EditShare GEEVs. Installation includes all labor, engineering, on-site commissioning, travel expenses, products, equipment, tools, and materials to fully install the specified EditShare product.  EditShare VBOX model o VBOX-I/O-HD-LT-4 Channel HD  4x HD-SDI configurable channels  Ingest and playback platform with maximum four (4) channels in any combination of In/Out with manual, gang, or scheduled recording. SDI (BMD) and NDI. Flow and EFS connection license included. o Capabilities  Capture and playback SRT, NDI, SDI, and ST2110 baseband video streams  Allows for scheduled recording, metadata management, ganged recording, and shotbox compatibility.

Statutory Compensation Coverage. Except as provided below, Contractor must provide Workers’ Compensation insurance for all its employees and, in case any work is subcontracted, Contractor will require the subcontractor to provide Workers’ Compensation insurance in accordance with the statutory requirements of the State, including Coverage B, Employer’s Liability. Insurance minimum limits are as follows: $100,000 – Bodily Injury by Disease per employee $500,000 – Bodily Injury by Disease aggregate $100,000 – Bodily Injury by Accident If Minn. Stat. § 176.041 exempts Contractor from Workers’ Compensation insurance or if the Contractor has no employees in the State, Contractor must provide a written statement, signed by an authorized representative, indicating the qualifying exemption that excludes Contractor from the Minnesota Workers’ Compensation requirements. If during the course of the contract the Contractor becomes eligible for Workers’ Compensation, the Contractor must comply with the Workers’ Compensation Insurance requirements herein and provide the State with a certificate of insurance. Privacy Liability Insurance (or equivalent). The coverage may be endorsed on another form of liability coverage or written on a standalone policy. The Contractor shall maintain insurance to cover claims which may arise from failure of the Contractor to ensure the security of not public data stored on the State’s documents, including but not limited to paper, microfilms, microfiche, magnetic computer tapes, cassette tapes, photographic negatives, photos, hard disks, floppy disks, and carbon sheets, while in the Contractor’s care, custody, and control. Insurance minimum limits are as follows: $2,000,000 - Per Occurrence $2,000,000 - Annual Aggregate The following coverage shall be included: State of Minnesota named as an Additional Insured unless the coverage is written under a Professional Liability policy. Exhibit C: Specifications, Duties, and Scope of WorkWork Scope: The work to be performed under this contract shall consist of furnish and installing one Canon TZ 30000 MFP Z36 complete with any other supplies, materials and incidentals necessary for service work completion. Product shall be installed onsite at Camp Xxxxxx, Little Falls, MN. The Contractor is responsible for loading and unloading equipment and for moving and setting in place. The Contractor shall provide all labor, materials, tools, and incidentals necessary to make the system fully operational in accordance to original equipment manufacturer’s intended use and functionality. Equipment initial start-up shall be performed and provided by the Contractor and must be completed by an approved/certified Manufacturer representative that also provides end users with training on controls, settings, and proper operation to include any applicable safety/safe operating practices. Contractor is responsible for removal and disposal of all garbage, packaging, etc. upon installation completion. Total price shall include all supplies, materials, equipment, labor, travel, mobilization, and incidentals necessary for successful completion of work. Location(s): Camp Xxxxxx FMO Building 2-1 00000 Xxxxxxx 000 Xxxxxx Xxxxx, XX 00000 Owner: Xxxx Xxxxxxxxx Design & Project Management – Camp Xxxxxx 00000 Xxxxxxx 000 Little Falls, MN 56345 Telephone: 000.000.0000 Product Description (No Substitute):‌ Qty 1 Canon TZ 30000 MFP Z36 Exhibit D: Pricing Contract Pricing. In General. Prices listed take into consideration all inherent costs of providing the requested goods and services. The Contractor agrees to pay any and all fees, including, but not limited to: duties, custom fees, permits, brokerage fees, licenses and registrations, government taxes, overhead, profit, parking permits, proper disposal of materials, insurance payments. The State will not pay any additional charges beyond the price(s) listed, unless otherwise provided for by law or expressly allowed by the Contract. Prices listed within Exhibit D are maximum prices. These maximum prices shall remain firm for the initial term of the Contract. The Price List may not include any additional terms or conditions. A unit price and a total for the quantity must be stated for each item quoted. Prices must be quoted in United States currency. Any increase to Contract pricing requires a duly executed amendment to this Contract. Contractor may provide lower pricing at its discretion without requiring a duly executed amendment to the Contract. SWIFT Line Description Unit Price 1 Canon TZ 30000 MFP Z36 EA $1.00 2 Installation JA $1.00 Installation Services. The Contractor must apply a charge as a separate line item for installation or mounting services if such service is requested in writing by the ordering entity. The price for equipment, attachments, or options does not include installation or mounting costs unless otherwise indicated in the Contract or Price Schedule. Prompt Payment Terms. Contractor’s payment terms are [TBD Delivery. Contractor must deliver the ordered goods [As soon as possible and not later than October 31, 2023], after receipt of order (ARO).

Statutory Compensation Coverage. Except as provided below, Contractor must provide Workers’ Compensation insurance for all its employees and, in case any work is subcontracted, Contractor will require the subcontractor to provide Workers’ Compensation insurance in accordance with the statutory requirements of the State, including Coverage B, Employer’s Liability. Insurance minimum limits are as follows: $100,000 – Bodily Injury by Disease per employee $500,000 – Bodily Injury by Disease aggregate $100,000 – Bodily Injury by Accident If Minn. Stat. § 176.041 exempts Contractor from Workers’ Compensation insurance or if the Contractor has no employees in the State, Contractor must provide a written statement, signed by an authorized representative, indicating the qualifying exemption that excludes Contractor from the Minnesota Workers’ Compensation requirements. If during the course of the contract the Contractor becomes eligible for Workers’ Compensation, the Contractor must comply with the Workers’ Compensation Insurance requirements herein and provide the State with a certificate of insurance. Privacy Liability Insurance (or equivalent). The coverage may be endorsed on another form of liability coverage or written on a standalone policy. The Contractor shall maintain insurance to cover claims which may arise from failure of the Contractor to ensure the security of not public data stored on the State’s documents, including but not limited to paper, microfilms, microfiche, magnetic computer tapes, cassette tapes, photographic negatives, photos, hard disks, floppy disks, and carbon sheets, while in the Contractor’s care, custody, and control. Insurance minimum limits are as follows: $2,000,000 - Per Occurrence $2,000,000 - Annual Aggregate The following coverage shall be included: State of Minnesota named as an Additional Insured unless the coverage is written under a Professional Liability policy. Exhibit C: Specifications, Duties, and Scope of WorkWork Final specifications will be the list of specifications, duties, and scope of work from Attachment F, attached to the solicitation, and will be inserted here for contract award as negotiated by the parties. Exhibit D: Pricing Contract Pricing. In General. Prices listed take into consideration all inherent costs of providing the requested goods and services. The Contractor agrees to pay any and all fees, including, but not limited to: duties, custom fees, permits, brokerage fees, licenses and registrations, government taxes, overhead, profit, parking permits, proper disposal of materials, insurance payments. The State will not pay any additional charges beyond the price(s) listed, unless otherwise provided for by law or expressly allowed by the Contract. Prices listed within Exhibit D are maximum prices. These maximum prices shall remain firm for the initial term of the Contract. The Price List may not include any additional terms or conditions. A unit price and a total for the quantity must be stated for each item quoted. Prices must be quoted in United States currency. Any increase to Contract pricing requires a duly executed amendment to this Contract. Contractor may provide lower pricing at its discretion without requiring a duly executed amendment to the Contract. SWIFT Line Description Unit Price 1 Astrophysics XIS-100DXV, or Approved Equal EA $1.00 2 1 meter entry and exit roller tables EA $1.00 3 Disposal of old system EA $1.00 4 Training EA $1.00 Prompt Payment Terms. Contractor’s payment terms are [to be completed based on response to the solicitation and any negotiations, (i.e., Net 30, 1% in 30 Net 31, etc.).]

Statutory Compensation Coverage. Except as provided below, Contractor must provide Workers’ Compensation insurance for all its employees and, in case any work is subcontracted, Contractor will require the subcontractor to provide Workers’ Compensation insurance in accordance with the statutory requirements of the State, including Coverage B, Employer’s Liability. Insurance minimum limits are as follows: $100,000 – Bodily Injury by Disease per employee $500,000 – Bodily Injury by Disease aggregate $100,000 – Bodily Injury by Accident If Minn. Stat. § 176.041 exempts Contractor from Workers’ Compensation insurance or if the Contractor has no employees in the State, Contractor must provide a written statement, signed by an authorized representative, indicating the qualifying exemption that excludes Contractor from the Minnesota Workers’ Compensation requirements. If during the course of the contract the Contractor becomes eligible for Workers’ Compensation, the Contractor must comply with the Workers’ Compensation Insurance requirements herein and provide the State with a certificate of insurance. Privacy Liability Property of Others Insurance (or equivalent). The coverage may be endorsed on another form of liability coverage or written on a standalone policy. The Contractor shall maintain a Property insurance to cover claims which may arise from failure policy covering “All Risk” of the Contractor to ensure the security of not public data stored on the State’s documentsdirect physical loss or damage, or equivalent, including but not limited to paperthe perils of theft, microfilmsflood, microfichetransit, magnetic computer tapes, cassette tapes, photographic negatives, photos, hard disks, floppy disksearthquake, and carbon sheets, while pollution clean‐up expense for property owned by the state that is in the Contractor’s care, custody, and control. Any deductible shall be the sole responsibility of the Contractor. Insurance minimum limits are as follows: $2,000,000 - Per Occurrence $2,000,000 - Annual Aggregate The following coverage shall be included: State of Minnesota named as an Additional Insured unless Contractor is solely responsible for the coverage is written under a Professional Liability policyequal to that of the actual cash value of state‐ owned property in the Contractor’s care, custody, and control at any given point in time. Exhibit C: Specifications, Duties, and Scope of WorkWork The Facility Maps show the Minnesota National Guard facilities by aerial view and address(es). The Facility Map defines the installation boundary (outlined in red); “Snow Removal” area (blue diagonal lines); and if applicable for the facility, “On Demand Snow Removal” area (yellow diagonal lines).

Statutory Compensation Coverage. Except as provided below, Contractor must provide Workers’ Compensation insurance for all its employees and, in case any work is subcontracted, Contractor will require the subcontractor to provide Workers’ Compensation insurance in accordance with the statutory requirements of the State, including Coverage B, Employer’s Liability. Insurance minimum limits are as follows: $100,000 – Bodily Injury by Disease per employee $500,000 – Bodily Injury by Disease aggregate $100,000 – Bodily Injury by Accident If Minn. Stat. § 176.041 exempts Contractor from Workers’ Compensation insurance or if the Contractor has no employees in the State, Contractor must provide a written statement, signed by an authorized representative, indicating the qualifying exemption that excludes Contractor from the Minnesota Workers’ Compensation requirements. If during the course of the contract the Contractor becomes eligible for Workers’ Compensation, the Contractor must comply with the Workers’ Compensation Insurance requirements herein and provide the State with a certificate of insurance. Privacy Liability Property of Others Insurance (or equivalent). The coverage may be endorsed on another form of liability coverage or written on a standalone policy. The Contractor shall maintain a Property insurance to cover claims which may arise from failure policy covering “All Risk” of the Contractor to ensure the security of not public data stored on the State’s documentsdirect physical loss or damage, or equivalent, including but not limited to paperthe perils of theft, microfilmsflood, microfichetransit, magnetic computer tapes, cassette tapes, photographic negatives, photos, hard disks, floppy disksearthquake, and carbon sheets, while pollution clean-up expense for property owned by the state that is in the Contractor’s care, custody, and control. Any deductible shall be the sole responsibility of the Contractor. Insurance minimum limits are as follows: $2,000,000 - Per Occurrence $2,000,000 - Annual Aggregate The following coverage shall be included: State of Minnesota named as an Additional Insured unless Contractor is solely responsible for the coverage is written under a Professional Liability policyequal to that of the actual cash value of state- owned property in the Contractor’s care, custody, and control at any given point in time. Exhibit C: Specifications, Duties, and Scope of WorkWork The MN Lottery participates in the MN State Fair event, we have a location at the Fairgrounds to accommodate the event activities. In this space we need to have a tent and subsequent materials indicated in this solicitation. Goal of this solicitation is to award a contract/purchase order to a vendor for providing the rental of a Tent & Floor Rental, Installation (Assembly/Disassembly) of products as well as Annual Storage for the lottery own materials. Delivery is for the vendor location to the Minnesota State Fairgrounds and pick up from the Minnesota State Fairgrounds delivering back to vendor location. o Rental components • Tent • Floor • Tracking system, • Lighting, • Fans, • Extension cords (banner frame) o Includes: o Transport to/from fairgrounds, o Assembly/disassembly; o Minnesota State Lottery (MSL)-owned plywood wall components and t-shirt bins to include: • Transport to/from fairgrounds, • Assembly/disassembly, and • Annual storage throughout contract period o Other items: • Install & uninstall MSL-provided signs, banners & logo stickers.