2-Insurance Certificate.doc.doc
DOC document 94 KB Posted
- Attached to
- Trailed Rotary Mower State and local contract opportunity
- Solicitation number
- ITQ-26-00337
- Issued by
- Hillsborough County, Florida
About this file
This is a Certificate of Liability Insurance document issued for Hillsborough County, a political subdivision of the State of Florida, in connection with a procurement for a trailed rotary mower valued at approximately $47,000. The certificate serves as proof that required insurance policies are in force and will remain active with a 30-day cancellation notice requirement. The document is a standard insurance certificate template that identifies coverage types, policy numbers, effective and expiration dates, and specified coverage limits across multiple insurance categories including General Liability, Automobile Liability, Garage Liability, Excess Liability, and Workers' Compensation and Employer's Liability.
Hillsborough County's Board of County Commissioners (BOCC) Risk Management Division, located at 601 E. Kennedy Boulevard, 17th Floor, Tampa, Florida 33602, is designated as the Certificate Holder with a fax number of 813-635-8284. The certificate requires that Hillsborough County be named as an Additional Insured on the listed General, Auto, and Aircraft Liability policies. The document confirms that contractual liability coverage is included in the General and Auto Liability policies and that the General Liability policies include a Separation of Insureds provision, ensuring distinct coverage for each insured party under the terms of this procurement.
View the file
Other files for this state and local contract opportunity
| File | Type | Posted |
|---|---|---|
| 5-ITQ-26-00337 Insurance Requirements.pdf | ||
| 1-Drug Free Workplace Form.doc.doc | DOC document | |
| 6-ITQ-26-00337 Trailed Rotary Mower.pdf | ||
| 7-ITQ-26-00337 Preliminary Bid Tabulation.pdf | ||
| 4-Direct Deposit Authorization Form 5.15.2025.pdf.pdf | ||
| 3-Substitute W9 Form.pdf.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, 17th FL
Tampa, FL 33602 Authorized Representative:
Signature _____________________________________
ICM – 015 (09/10)
File details come from the government source that posted it. Updated .