Sample Certificate of Liability Insurance~68.pdf

PDF 812 KB Posted

Attached to
27AL2369 Pyramid State Park - Galum Unit Farm Lease
Solicitation number
27-422DNR-REALT-B-54126
Issued by
Illinois

About this file

This is a Sample Certificate of Liability Insurance document provided by the Illinois Department of Natural Resources (IDNR) for the Pyramid State Park - Galum Unit Farm Lease contract opportunity. The document serves as a template for contractors to demonstrate required insurance coverage for agricultural farming services on state-owned property. The certificate requires contractors to list multiple policy numbers with corresponding start and end dates, and emphasizes that all required fields must be completed regardless of applicability. The IDNR must be listed as an additional insured on the policies, and the document specifies minimum contract requirements for coverage amounts, though additional coverage may be included at the contractor's discretion.

The certificate of liability insurance document is provided for informational purposes only and does not supersede the requirements of any executed farm lease agreement. The contractual terms of the actual executed farm lease between the tenant farmer and the IDNR control and take precedence over this sample template. Contractors bidding on this opportunity must comply with the insurance requirements outlined in the attached Invitation for Bid (IFB) documentation, which contains detailed information regarding specific locations, acreage, and additional contractual obligations for the farming services on the designated state park property.

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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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