2-Insurance Certificate.doc
DOC document 94 KB Posted
- Attached to
- Countywide Sidewalk Grinding State and local contract opportunity
- Solicitation number
- ITB-26-00342
- Issued by
- Hillsborough County, Florida
About this file
This is an Insurance Certificate document related to the Countywide Sidewalk Grinding contract opportunity issued by the Hillsborough County Board of County Commissioners in Florida. The document establishes insurance requirements that bidders and contractors must maintain throughout the contract term. The certificate serves as proof of insurance coverage and outlines the minimum coverage types, limits, and conditions necessary for contract performance. Contractors must provide evidence of current insurance maintained for the duration of the two-year contract period for sidewalk grinding services at various locations throughout Hillsborough County.
The insurance certificate specifies the required coverage amounts and types that contractors must obtain, including general liability, workers' compensation, and other pertinent insurance protections. All insurance policies must name Hillsborough County as an additional insured and maintain continuous coverage without lapse throughout the contract performance period. The certificate document serves as a prerequisite submission for bid qualification and must be provided prior to contract award, with the contractor maintaining active coverage throughout the two-year contract term with an estimated project value of $1,949,995.50.
View the file
Other files for this state and local contract opportunity
| File | Type | Posted |
|---|---|---|
| 1-Drug Free Workplace Form.doc | DOC document | |
| 6-ITB-26-00342 Countywide Sidewalk Grinding.pdf | ||
| 3-Substitute W9 Form.pdf.pdf | ||
| 4-Direct Deposit Authorization Form 5.15.2025.pdf.pdf | ||
| 5-ITB-26-00342 Insurance Requirements.pdf |
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Text version
CERTIFICATE OF LIABILITY INSURANCE
Date:
Producer, Address, Telephone No.
Insurers Affording Coverage
Insurer A:
Insurer B:
Insured, Address
Insurer C:
Insurer D:
Insurer E:
This is to certify that the insurance policies listed below have been issued to the insured and are in force at this time. It is further certified that these policies have been endorsed to provide that they will not be cancelled or changed so as to reduce the described coverages until 30 days after written notice of such cancellation or change has been delivered to the certificate holder at the address shown below.
Insr
Ltr
| Type of Insurance |
| Policy Number |
| Policy Effective Date |
| Policy Expiration Date |
| Limits |
| General Liability |
FORMCHECKBOX
Commercial General Liability
FORMCHECKBOX
Claims Made FORMCHECKBOX Occur
FORMCHECKBOX
FORMCHECKBOX
General Aggregate Limit Applies per:
FORMCHECKBOX
Policy FORMCHECKBOX Project FORMCHECKBOX Loc
| Each Occurrence |
| $ |
| Fire Damage |
| $ |
| Personal & Advertising Injury |
| $ |
| General Aggregate |
| $ |
| Products – Completed Operations Aggregate |
| $ |
| Automobile Liability |
FORMCHECKBOX
Any Auto
FORMCHECKBOX
All Owned Autos
FORMCHECKBOX
Scheduled Autos
FORMCHECKBOX
Hired Autos
FORMCHECKBOX
Non-Owned Autos
FORMCHECKBOX
FORMCHECKBOX
| Combined Single Limit (Each Accident) |
| $ |
Bodily Injury
(Per Person)
Bodily Injury
(Each Accident)
Property Damage
(Per Accident)
| Garage Liability |
FORMCHECKBOX
Any Auto
FORMCHECKBOX
| Auto Only – Ea Acc |
| $ |
Other than Ea Acc Auto Only:
Aggregate
| Excess Liability |
FORMCHECKBOX
Occur FORMCHECKBOX Claims Made
FORMCHECKBOX
Deductible
FORMCHECKBOX
Retention $
| Each Occurrence |
| $ |
| Aggregate |
| $ |
| Workers’ Compensation and |
Employer’s Liability
| FORMCHECKBOX |
WC Statu- FORMCHECKBOX Oth-tory Limits er
| E. L. Each Accident |
| $ |
| E. L. Disease – Ea Emp |
| $ |
| E. L. Disease – Pol Limit |
| $ |
| Other |
| $ |
FORMCHECKBOX
Contractual Liability Coverage is Included in listed General and Auto Liability Policies.
FORMCHECKBOX
“Hillsborough County, a political subdivision of the state of Florida” has been named as an Additional Insured on the listed General, Auto and Aircraft Liability Policies.
FORMCHECKBOX
Listed General Liability Policies include a Separation of Insureds (severability of interests) provision.
FORMCHECKBOX
Other Provisions/Limitations/Conditions:
Certificate Holder: Fax No. 813-635-8284 Hillsborough County - BOCC
Risk Management Division
601 E. Kennedy Blvd, 26th FL
Tampa, FL 33602 Authorized Representative:
Signature _____________________________________
ICM – 015 (09/10)
File details come from the government source that posted it. Updated .