Sample Certificate of Liability Insurance~30.pdf

PDF 812 KB Posted

Attached to
26AL2193 Johnson Sauk Trail S. P. Farm Lease
Solicitation number
26-422DNR-REALT-B-49118
Issued by
Henry County, Illinois

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Written by GovTribe AI ·

This document is a Sample Certificate of Liability Insurance issued by an insurance broker for a Tenant Farmer, with the Illinois Department of Natural Resources listed as the certificate holder. The form is an ACORD 25 standard insurance certificate template, which provides details about insurance coverage types and limits. The certificate covers Commercial General Liability insurance with a policy limit of $1,000,000 per occurrence and a $2,000,000 general aggregate limit.

The insurance document specifies coverage for automobile liability under the "ANY AUTO" category and includes a note that the document is intended for informational purposes only and does not supersede the requirements of any executed farm lease between the tenant farmer and the Illinois Department of Natural Resources (IDNR). The policy appears to be a standard commercial insurance document that demonstrates the insured party's coverage and compliance with potential contractual insurance requirements, with specific limits and policy details outlined on the form.

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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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File details come from the government source that posted it. Updated .