Sample Certificate of Liability Insurance~60.pdf

This is a sample Certificate of Liability Insurance document provided by the Illinois Department of Natural Resources (IDNR) for use in connection with the Double "T" State Fish and Wildlife Area Farm Lease opportunity. The document serves as a template for contractors and tenant farmers to demonstrate compliance with insurance requirements associated with agricultural farming services on state-owned property. The certificate requires contractors to list policy numbers, start dates, and end dates for multiple insurance policies, with specific notation that the IDNR must be listed as an additional insured on the applicable coverage. The document explicitly states that it is intended for informational purposes only and does not supersede the requirements of any executed farm lease agreement.

The document emphasizes minimum insurance coverage amounts required by law and minimum contract requirements, with provisions for additional coverage information as needed. All relevant sections of the certificate must be completed by the contractor, even if the response to certain questions is negative. The document includes highlighted sections indicating areas of particular importance for completion and compliance. Notably, the certificate clarifies that contractual terms of an executed farm lease between the tenant farmer and IDNR will control over the requirements outlined in this sample document, establishing that actual policy requirements will be determined by the final lease agreement.