ESBD_399645_1740777144286_Sample Insurance form.pdf

This is a sample ACORD Certificate of Liability Insurance form shown for Plano ISD, located at 6600 Alma Dr, Plano, TX 75075. The certificate appears to be a standard template showing various types of insurance coverage including general liability, automobile liability, garage liability, excess/umbrella liability, and workers compensation and employer's liability.

The form contains blank sections for policy numbers, effective dates, expiration dates, and coverage limits across different insurance categories. A key provision states that Plano ISD shall be added as additional insured as required by statute, contract, purchase order or otherwise requested, with insurance being primary over other available sources. The form also includes standard cancellation language requiring advance written notice to the certificate holder before policy cancellation.