Sample Certificate of Liability Insurance~11.pdf
PDF 812 KB Posted
- Solicitation number
- 25-422DNR-DIREC-B-45882
- Issued by
- Grundy County, Illinois
About this file
This is a sample ACORD Certificate of Liability Insurance template that would be required for tenant farmers contracting with the Illinois Department of Natural Resources (IDNR). The certificate template shows required coverage types and minimum limits, including Commercial General Liability with $1,000,000 per occurrence and $2,000,000 general aggregate limits, Automobile Liability with $1,000,000 combined single limit, and Workers' Compensation coverage if applicable.
The certificate names IDNR as the certificate holder with their Springfield, IL address and specifies that IDNR should be listed as an additional insured. Key notes indicate that this document is for informational purposes only and does not supersede requirements of any executed farm lease agreement between tenant farmers and IDNR. The template includes red annotations highlighting important completion requirements and minimum coverage amounts required by law.
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Other files
| File | Type | Posted |
|---|---|---|
| 25AL2165 Hamilton County SFWA Farm Lease IFB~2.docx | DOCX document | |
| Vendor Disclosures - Formerly Forms A~61.docx | DOCX document | |
| Attachments A-K~20.pdf | ||
| 25AL2165 Hamilton County SFWA Farm Lease Pre-Bid Conference Information~1.docx | DOCX document | |
| SPO Signed B-45882 NOA.pdf | ||
| IL State Board of Elections Registration Manual~53.pdf | ||
| IPG Active Registered Vendor Disclosure - Formally Forms B v.23.1~57.docx | DOCX document |
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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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