Insurance Certificate Sample.pdf

This is an insurance certificate sample document for the City of Hartford and Hartford Public Schools in Connecticut. The document outlines insurance requirements for contractors working on projects for these entities. The certificate specifies that the City of Hartford and Hartford Public Schools must be named as additional insureds under an AIIMA (Additional Insured – Managers, Architects & Engineers) endorsement on a primary non-contributory basis, contingent upon written contract requirements executed prior to any loss or claim. The document provides the City of Hartford's address as 550 Main Street, Hartford, CT 06103, and references smsheppard as a point of contact.

The certificate includes a waiver of subrogation provision that applies in favor of the certificate holder as specified in the policy terms, provided that such waiver is required in a written contract with the named insured and that contract has been executed prior to loss or claim. This sample certificate serves as a template for contractors to understand the insurance and liability requirements necessary for engagement with the City of Hartford and Hartford Public Schools on projects such as the Architectural and Engineering Services with Landscape Design for Colt Park Carriage House and Gardener's Cottage Structural Stabilization project.