Exhibit F - COI Template.pdf
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- Solicitation number
- 1019A-2025 (Second Solicitation)
- Issued by
- Denver County, Denver City, Colorado
About this file
This document is a Contractor Certificate of Liability Insurance template issued by the City and County of Denver for contractors seeking to work with the municipal government. The template provides specific guidelines for insurance certificate submission, requiring contractors to demonstrate appropriate insurance coverage with precise formatting and content requirements. The document outlines mandatory sections including contractor's legal name, types of insurance required, policy limits, and additional insured provisions. Contractors must ensure their insurance certificates exactly match the specimen form, with critical details such as policy start dates being prior to the contract's effective date and policy limits meeting or exceeding contract requirements.
The certificate emphasizes strict documentation standards, specifically prohibiting additional qualifying language beyond the prescribed text. The description box must only contain the contract name/number and a standard additional insured statement. The City and County of Denver reserves the right to reject certificates that do not precisely meet these specifications or to move to alternative contractors if requirements cannot be fully complied with. The template is designed to ensure comprehensive insurance coverage and protect the municipal government's interests by standardizing insurance documentation across all contractor relationships.
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Text version
City and County of Denver Contractor
DENVER
THE MILE HIGH CITY
Certificate of Insurance
Contractors, please provide this sample certificate to your insurance agent or broker
Certificates must mirror this sample
Note the Additional Insured special instructions below
Contractor’s Legal Name
Types of insurance required in contract
If other insurance (Builders’ Risk, Professional Liability, for example) is required, please list it here
Only project/contract info and additional insured in this box*
Verify correct address & contact information
Tituruimo flrtcr NAmo & Adifrco U
11062)AFFORIP*O COAfl500 Cant
.,aA monO
Cctruilors to.oI Stan .ini AddYosY PalICO a ps—n’
COVERAGES CERTIFICATE NUUBER: REVISION NUMBER:
THIS ii. ... THAT TIlE POJCIES OF .* ,.,.. .. •...
IC3TED TOTWTH5TAICOIG ANT REOIJREVEIfl TERM OR COCOTION OF AMY CONTRACT OR OTHER OOCI*RIW RITE RESPECT To MUCH OHS CERTiFICATE MAY BE ISSUED OH MAY PERTAIN THE IIinURfiOICE AFFORORD BY THE POliCIES COSORRED HEREIN IS R5.ISCT TO Au. 0€ TERMS EECWUOMA AVE CONOOl4S OF SUCH POliCIES ClEATS 5HDMI MAY HAVE SEEN REELICED BY PAID CI.AJUS.
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As reuuired by written contract, the City and County olDenvcr, is Elected and Appointed Officials. Employees and Volunteers arc included us Additional Insured us respects the Commercial tieneral Liability and llnainess AtSo
ISIS
must be same or greater than
Z required in the contract
Policy start date
/ must be prior to effective date of the contract
*The ‘description’ box must only contain project/contract detail such as the contract name and number and “As required by written contract, the City and County of Denver, its Elected and Appointed Officials, Employees and Volunteers are included as Additional Insured” with regards to the appropriate policies ONLY.
QUALIFYING LANGUAGE SUCH AS “SUBJECT TO THE TERMS AND CONDITIONS OF THE POLICY”
and “IF REQUIRED PER WRITTEN CONTRACT” CAN NOT BE ADDED.
DO NOT ATTACH ADDITIONAL INSURED ENDORSEMENTS OR POLICIES
If any additional language is added to this section, the certificate will be rejected. If the requirements can not be complied with, we reserve the option to move on to another contractor
ACQRD CERTIFICATE OF LIABILITY INSURANCE I
ThIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATiON ONLY AND CONFERS NO RIGHTS UPON TEE CERTTFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND. EXTEND OR ALTER THE COVERAGE AFFORDED BY ThE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN TUE ISSUING INSURER(SI. AUThORIZED
REPRESENTATIVE OR PRODUCER. AND TEE CERTIFICATE UOLDER
IISPORIANI: A .,o m.,on n..a, ,* pnnnoG. ON polmypeat nO.515. eHAo,s.IF ,,.ornn,A,. ,.co.. USING Is Re lINen d COndfllse. .5 ON polIcy. Anile poW... may mqsSn I. pndon.mnd. A AstemaIN O0 PUB nHIRORO doss fbI noldn UgNA Is ON
Policy limits
C d C’ r . . WOULD ANY CF TIlL ABOVE DESCSISOD POLICIES BE CANCELLED I€Fii> an OUnO It THE EXPRMTIGN OATS THEREOF. NOTICE WILl. BE ECI.XUCRED WI l)tpartmeni oI — AECOWOUBEC am s.€ PoliCY PWoVEDCNS tAddee&s) - Dept Denver. (‘olorudo --
C TBU.DETD ACORO CORPORATiON. AU Ughts tRIp,V.d.
ACORD 25 1201 Q1QU) The ACORO name and logo me r.giBRr.d mains of ACORD
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