Sample Certificate of Liability Insurance~26.pdf

PDF 812 KB Posted

Attached to
25AL2036 Kaskaskia River S. F. W. A. - Farm Lease
Solicitation number
25-422DNR-REALT-B-44657
Issued by
St. Clair County, Bartelso Village, Illinois

About this file

This document is a Sample Certificate of Liability Insurance related to a state and local contract opportunity. The certificate indicates the required policy number, start and end dates, and minimum liability coverage amounts. The Indiana Department of Natural Resources (IDNR) should be listed as an additional insured, and the minimum contract requirements are specified. This document is intended for informational purposes only, and the contractual terms of an executed farm lease between the tenant farmer and the IDNR take precedence.

The certificate does not provide details on pricing terms, set asides, incumbents, funding requirements and sources, or other salient information beyond the liability insurance requirements. The document appears to be a standard insurance certificate template rather than a full solicitation or contract 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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