Vendor/Contractor Application Form

Vendor/Contractor Application Form

**** Each Shipyard Requires a Separate Application and COI ****

INSURANCE INFORMATION

Certificate of Insurance Upload

Understand Requirements Before Visiting Derecktor Shipyards

All companies engaged in business and requiring access to facilities at Derecktor of Florida or Derecktor Ft. Pierce, regardless of their billing status, must provide our offices with Certificates of Insurance showing "Derecktor of Florida, Inc." (Dania Yard) or "Derecktor Ft. Pierce, LLC" (Fort Pierce Yard) as the certificate holder including: address and identify the particular Derecktor facility as an additional insured. Each yard (facility) will require its own specific COI certificate.

Minimum Subcontractor Insurance Coverage Requirements

• General Liability: ($2,000,000 minimum)

• Ship Repairer’s Liability Insurance (Must include a notation on the GL COI showing coverage)

• Worker’s Compensation:

• Option 1: Worker’s Comp COI

• Option 2: Worker’s Comp Exemption + United States Longshore & Harbor Workers (USL&H)

• Automotive: For vehicles entering the yard

Certificates of Insurance must be registered at our offices prior to entry into our shipyard(s). Upload certificates by clicking the "browse file" link below

Drag and drop files here or

Derecktor Shipyard Location*

Select

Insurance (COI) Agent Name

Insurance (COI) Agent Email

Insurance (COI) Agent Phone

Certificate of Insurance Expiration Date

General Liability COI Number

General Liability Expiration Date

Worker Comp COI Number

SRLI

USL&H

WC Exempt

COMPANY INFORMATION

Company Name*

Contact Name*

Contact Title

Contact Phone*

Company Contact Email*

Office Phone (Company)

Address Street (Company)

Address City (Company)

Address State (Company)

Address Zip (Company)

Contact Type*

Select

Contact Subtype

Select or enter value

Billing Address Street

Billing Address City

Billing Address State

Billing Address Zip

Notes

No Unauthorized Photography/Video*

All companies or individuals engaged in business at Derecktor shipyards (Derecktor of Florida, Inc or Derecktor Ft. Pierce, LLC) acknowledge and agree that, except as expressly permitted by (Derecktor of Florida, Inc or Derecktor Ft. Pierce, LLC) with respect to Yachts that such companies may be performing services or work upon, they shall not:

1) publish, post, or otherwise disseminate (on any social media of any kind or otherwise) information or audio or video recordings or depictions that could reasonably be expected to reveal any Confidential Information (such as, but not limited to, the Yachts’ operations, itinerary, ownership or activities); or

2) create any photographs, videos or other visual recordings of the interior or exterior of the Yachts or any trips associated therewith, except that visual recordings created to convey information to Derecktor shipyards, its representatives, or customers regarding conditions on the Yachts are permitted. Such photographs shall be treated as Personal Information and shall not be distributed to anyone other than Derecktor shipyards, its representatives or customers that need them for the benefit of the Yachts or the Owner.

Acknowledge and Agree by checking the below box

REQUIREMENTS FOR ALL SUBCONTRACTORS

All companies engaged in business at any Derecktor Shipyard , regardless of their billing status, must provide Certificates of Insurance showing "Derecktor of Florida, Inc." (Dania Yard) or "Derecktor Ft. Pierce, LLC" (Fort Pierce Yard) as the certificate holder including address and identify the specific Derecktor yard as an additional insured. This document must show proof of General Liability Insurance including Ship Repairers Liability Insurance (SRLI), and pollution insurance if applicable, with effective dates of policy and minimum limits of $1,000,000 of coverage per incident and $2,000,000 of overall coverage; Worker’s Compensation Insurance (WC) coverage with minimum $1,000,000 of coverage per incident and $2,000,000 of overall coverage. A company with less than three employees may utilize a WC exemption as long as they provide proof of valid United States Longshore & Harbor workers (USL&H) coverage. Automobile Liability Insurance must also be registered with our office in order to drive a vehicle into the facility. Contractors who may be working directly for a vessel must still provide the Certificates of Insurance listed above.

Valid Certificates of Insurance must be on file with our office and kept in a current status prior to performance of any work on our property and it is the responsibility of each Subcontractor to insure current insurance requirements are forwarded to us as policies renew in order to remain on our active subcontractor listing.

The above Certificates of Insurance must be registered in our office in order to perform work in our facility.

All work for Derecktor is to be performed pursuant to a Derecktor Shipyard Purchase Order and each subcontractor must register their Federal Tax I.D. Number with our Purchasing Department.

Subcontractors must sign in and out at the front gate on a daily basis, indicating the name of the vessel or the project on which they are working. Subcontractors are required to comply with all applicable shipyard safety rules, environmental laws and OSHA laws and regulations and are expected to clean the area in which they working and dispose of all their own work waste.

Derecktor Shipyard is open to subcontractors from 7:00 am to 4:00 pm Monday through Friday. Weekends and after hours must be approved in writing by Management.

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