Sample Certificate of Liability Insurance~70.pdf

PDF 812 KB Posted

Attached to
27AL2380 Pyramid State Park - Denmark Unit Farm Lease
Solicitation number
27-422DNR-REALT-B-54170
Issued by
Illinois

About this file

This is a Sample Certificate of Liability Insurance document related to an agricultural farming services lease opportunity through the Illinois Department of Natural Resources for Pyramid State Park - Denmark Unit Farm Lease (Contract ID: 27AL2380). The certificate template is designed to document proof of insurance coverage that would be required from bidders or awarded contractors performing farming operations on state-owned property. The document would typically include fields for the insured party's name, policy effective and expiration dates, coverage limits for general liability, and policy holder contact information, serving as verification that the contractor maintains adequate insurance protection during the term of the lease agreement.

This sample certificate establishes the insurance documentation standards that applicants must provide as part of their bid submission or contract execution requirements. The certificate would need to demonstrate minimum coverage amounts and types of liability protection deemed necessary by the Illinois Department of Natural Resources for agricultural operations conducted on state park property. The specific insurance requirements, coverage limits, and policy specifications would be detailed in the main Invitation for Bid document and any supplementary contract terms governing the farm lease operation.

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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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