2-Certificate of Liability Insurance Sample - Acord 25.pdf
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- Solicitation number
- RFSCP #2026-001
- Issued by
- Upton County, Texas
About this file
This is a Certificate of Liability Insurance sample document (ACORD 25 form) required by the Laredo Independent School District for all vendors and contractors participating in the Metal Canopies project at Katherine F. Tarver Elementary School in Texas. The document outlines the mandatory insurance requirements and coverage specifications that vendors must provide prior to contract execution. All vendors and contractors must submit a completed Certificate of Insurance to Laredo ISD, with the certificate holder listed as the school district at 900 East Lyons, Laredo, TX 78040.
The required insurance coverage includes General Liability with limits of $1,000,000, Auto Liability at $1,000,000, Workers' Compensation at statutory limits, and Umbrella/Excess coverage at $5,000,000. The certificate must designate Laredo ISD as an Additional Insured on General Liability, Automobile, and Umbrella Liability policies, with a Waiver of Subrogation on all policies including Workers' Compensation. Coverage must be primary and non-contributory with respect to General Liability, Automobile, and Umbrella Liability. All policies must provide 30 days' notice of cancellation to the certificate holder, except in cases of non-payment where 10 days' notice applies. The document notes that higher limits may be required depending on project specifications.
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Text version
The following outlines a sample Certificate of Insurance which should be provided to Laredo ISD from ALL Vendors / Contractors..
Insurance Agent / Broker Providing Certificate And Address
A x xx x x x
A
B
A
Insurance Agent/Broker Providing Certificate
Vendor / Contractor / Lessee/ Name Needs to Agree With Contract
Date Issued
Insurance Company
Writing Policy
General Liability
Auto Liability
Umbrella Excess (Limits can be combined with
AL, GL and/or EL to meet req.)
Workers’ Compensation
Commercial General Liability & Occurrence Based
Location name & mailing address: This is where notice of cancellation will be mailed to.
NOTICE OF CANCELLATION
Require 30 days but some agents will not issue more than 10 days because policies can be cancelled in 10 days for non-payment.
Certificate Holder is included as Additional Insured as respects General Liability, Automobile & Umbrella Liability policies and granted a Waiver of Subrogation on all policies including Workers Compensation. Coverage is primary and non-contributory as respects to General Liability, Automobile & Umbrella Liability. In the event of cancellation by the insurance companies all policies have been endorsed to provide (30) days Notice of Cancellation (except (10) days for non-payment) to the certificate holder shown below.
Customary Limits for Umbrella attachment xWC Statutory Limits 1,000,000 1,000,000 1,000,000
5,000,000 5,000,000
Note: Higher limits may be required
8783009889 1/1/2018 1/1/2019
1/1/2018 1/1/2019
ABCE897658 1/1/2018 1/1/2019
XYZ2243433334 1/1/2018 1/1/2019
1,000,000
100,000 50,000
1,000,000 2,000,000 2,000,000
1,000,000
ALL 3 Boxes Checked Also OK
Company A Company B x
Limits Required in ALL Four
Laredo Independent School District 900 East Lyons Laredo, TX 78040
Vendor / Contractor / Lessee Address Name Needs to Agree with Contract
Recommended wording
Slide Number 1
File details come from the government source that posted it. Updated .