Sample Certificate of Liability Insurance~37.pdf

This document is a Sample Certificate of Liability Insurance issued by an insurance broker for a Tenant Farmer, with the Certificate Holder being the Illinois Department of Natural Resources located in Springfield, Illinois. The certificate is an ACORD form designed to provide proof of insurance coverage, specifically outlining commercial general liability and automobile liability insurance policies. The document includes spaces for policy numbers, coverage dates, and insurance limits, with a standard $1,000,000 occurrence limit for commercial general liability and a $2,000,000 general aggregate limit.

The certificate serves as an informational document only and does not supersede the requirements of any executed farm lease. It is intended for informational purposes and is specifically related to an IDNR (Illinois Department of Natural Resources) control context. The form provides placeholders for multiple insurers, policy details, and critical insurance coverage information, including sections for workers' compensation, proprietary operations, and other relevant insurance categories. Notable details include a requirement to complete all sections, even if the response is "N/A", and a disclaimer that the certificate does not confer rights or alter the coverage afforded by the underlying insurance policies.