Sample Certificate of Liability Insurance~1.pdf

PDF 812 KB Posted

Attached to
25AL2193 Johnson Sauk Trail S. P. - Farm Lease
Solicitation number
25-422DNR-DIREC-B-45557
Issued by
Henry County, Illinois

About this file

This document is a Sample Certificate of Liability Insurance related to a state or local contract opportunity. The certificate indicates that the required minimum liability insurance coverage must be in place, with the IDNR listed as an additional insured. The minimum contract requirement for liability coverage is stated, though additional coverage or information may be included. The document notes that it does not supersede the requirements of any executed farm lease, and is for informational purposes only, with the contractual terms of the executed farm lease controlling.

The pricing terms, set asides, incumbents, funding requirements, and other salient financial details are not provided in this Certificate of Liability Insurance document. The focus is solely on the insurance coverage requirements for the state or local contract opportunity.

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Text version

SAMPLE CERTIFICATE OF LIABILITY INSURANCE.

POLICY NUMBER START

DATE

END DATE

POLICY NUMBER START

DATE

END DATE

POLICY NUMBER

(IF APPLICABLE)

START

DATE

END DATE

nicole.thomas Line nicole.thomas Text Box This box MUST be completed, even if the response is "N".

nicole.thomas Text Box Minimum amount required by law, if applicable.

nicole.thomas Line nicole.thomas Line nicole.thomas Line nicole.thomas Text Box IDNR should be listed as additional insured.

nicole.thomas Line nicole.thomas Line nicole.thomas Text Box Minimum contract requirement. Additional coverage/info may be included.

nicole.thomas Line nicole.thomas Line nicole.thomas Line nicole.thomas Text Box This document does not supersede the requirements of any executed farm lease. This document is intended for informational purposes only. Contractual terms of an executed farm lease between the tenant farmer and the IDNR control.

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