Sample Certificate of Liability Insurance~66.pdf

PDF 812 KB Posted

Attached to
27AL2336 Pyramid State Park - Captain Unit Farm Lease
Solicitation number
27-422DNR-REALT-B-54168
Issued by
Illinois

About this file

This is a Sample Certificate of Liability Insurance document from the Illinois Department of Natural Resources (IDNR) related to the Pyramid State Park – Captain Unit Farm Lease opportunity. The certificate template outlines the required insurance documentation that bidders and contractors must provide when responding to the agricultural farming services solicitation. The document requires contractors to identify policy numbers, start dates, and end dates for multiple insurance policies, with specific emphasis on completing all required fields regardless of applicability. IDNR must be listed as an additional insured on the certificate, and the document indicates minimum contract requirements for coverage amounts, which may be supplemented with additional coverage information as needed.

The certificate clarifies that it serves an informational purpose only and does not supersede the requirements of any executed farm lease agreement. The contractual terms of the executed farm lease between the tenant farmer and IDNR control the final requirements. The document includes notation that minimum amounts required by law and minimum contract requirements must be met, with specific reference to compliance with farm lease obligations. This certificate template establishes baseline insurance expectations for potential bidders on the state-owned agricultural property within Pyramid State Park.

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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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