Sample Certificate of Liability Insurance~73.pdf

This is a Sample Certificate of Liability Insurance document prepared by the Illinois Department of Natural Resources (IDNR) for use in connection with the Wayne Fitzgerrell State Park Farm Lease contract opportunity. The certificate serves as a template for contractors to demonstrate required insurance coverage and includes designated fields for policy numbers, start dates, and end dates across multiple insurance policies. The document requires completion of all sections, including notation if certain coverage types are not applicable, and mandates that IDNR be listed as an additional insured on the relevant policies. The certificate is intended for informational purposes and establishes minimum insurance requirements necessary for agricultural farming services on state-owned property within the park.

The document specifies that minimum coverage amounts are required by law where applicable, with additional coverage or information potentially included based on specific contract requirements. A critical notation indicates that the certificate does not supersede the requirements of any executed farm lease agreement, and the actual contractual terms between the tenant farmer and IDNR control over the provisions outlined in this sample document. This template appears designed to standardize insurance documentation requirements across farming lease agreements managed by the state agency.