2-Insurance Certificate.doc

DOC document 94 KB Posted

Attached to
Irrigation Installation Services
Solicitation number
ITB-25-00248
Issued by
Hillsborough County, Florida

About this file

This document is a Certificate of Liability Insurance for Hillsborough County, Florida, specifically for the Hillsborough County Board of County Commissioners (BOCC) Risk Management Division. The certificate confirms that insurance policies are in force for an unnamed insured, with coverage provisions for general liability, automobile liability, excess liability, and workers' compensation. The insurance policies are endorsed to provide 30 days' written notice before cancellation or changes to coverage, and Hillsborough County is named as an additional insured on the general, auto, and aircraft liability policies.

The related state and local contract opportunity involves Hillsborough County Parks and Recreation Department seeking a qualified contractor for ongoing irrigation system installation services across various county locations. The project is structured as a four-year contract with an estimated budget of $244,333.50, indicating a comprehensive approach to irrigation infrastructure maintenance and installation. The certificate ensures that the selected contractor maintains appropriate insurance coverage, protecting the county's interests throughout the duration of the project by providing comprehensive liability protection across multiple insurance categories.

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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 .