3-Certificate of Liability Insurance Sample - Acord 25 (1).pdf
PDF 645 KB Posted
- Attached to
- Contractors for General Repairs, Maintenance, Remodeling a & Special Projects (1st Yr. )
- Solicitation number
- RFP 26-010
- Issued by
- Upton County, Texas
About this file
This is a Certificate of Liability Insurance sample document (ACORD 25 form) provided by Laredo Independent School District in Texas as a requirement for all vendors and contractors engaging in work for the district. The document outlines mandatory insurance coverage requirements that must be maintained throughout the contract period, including general liability, auto liability, umbrella/excess liability, and workers' compensation insurance. All vendors and contractors must submit a certificate of insurance to Laredo ISD at 900 East Lyons, Laredo, TX 78040 prior to commencing work, with the certificate holder designated as an additional insured on all applicable policies.
The certificate must specify minimum coverage limits of $1,000,000 for general liability and auto liability, $1,000,000 for workers' compensation (statutory limits), and $5,000,000 for umbrella/excess liability coverage. Insurance policies must be primary and non-contributory with respect to general liability, automobile, and umbrella liability coverage, and must include a waiver of subrogation on all policies including workers' compensation. All policies must include a 30-day notice of cancellation provision (10 days permitted for non-payment only) with notice directed to the certificate holder. The insurance agent or broker information, insurance company details, policy numbers, and effective dates must be clearly documented on the certificate, with all required coverage types marked as selected.
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Other files
| File | Type | Posted |
|---|---|---|
| 8-04 RFP~1.PDF | ||
| 4-00 RFP~1.PDF | ||
| 11-07 RFP~1.PDF | ||
| 5-01 RFP~1.PDF | ||
| 1-General Terms and Conditions R3.7.25.pdf | ||
| 7-03 RFP~1.PDF | ||
| 2-1295 Example 1.pdf | ||
| 10-06 RFP~1.PDF | ||
| 12-08-A R~1.PDF | ||
| 9-05 RFP~1.PDF | ||
| 6-02 RFP~1.PDF | ||
| 13-08-B R~1.PDF |
Show all 12
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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
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