Sample Certificate of Liability Insurance~35.pdf

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 (IDNR) listed as the certificate holder. The form is an ACORD 25 standard insurance certificate template, which provides details about commercial general liability and other insurance coverage. The certificate indicates coverage limits of $1,000,000 per occurrence for commercial general liability and $2,000,000 general aggregate, with a $1,000,000 combined single limit for products-completed operations.

The document explicitly states that it does not supersede the requirements of any executed farm lease and is intended for informational purposes only, specifically for IDNR control. The certificate serves as a matter of information and does not confer rights upon the certificate holder, with important notes about potential additional insured provisions and policy endorsements. The form includes placeholders for multiple insurers, policy numbers, and coverage start and end dates, though these are not filled in on this sample document.