Sample Certificate of Liability Insurance~74.pdf
PDF 812 KB Posted
- Solicitation number
- 27-422DNR-REALT-B-54128
- 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 use in connection with the Pyramid State Park - Captain Unit Farm Lease bidding opportunity. The certificate template establishes the insurance documentation requirements that bidders and contractors must provide as part of their bid submission and contract execution. The document requires completion of policy information across multiple insurance types, with specific start and end dates for each policy line. Notably, the IDNR must be listed as an additional insured on the required policies, and the document specifies that minimum contract requirements apply, with additional coverage or information potentially required depending on the specific terms of the executed farm lease.
The certificate serves an informational purpose and does not supersede the requirements of any executed farm lease agreement between the tenant farmer and IDNR. The document emphasizes that contractual terms established within an executed farm lease control over the provisions outlined in the certificate template. All required boxes must be completed, including those addressing minimum amounts required by law where applicable, even if the response indicates that certain coverage is not applicable. This insurance documentation is a prerequisite for participation in the agricultural farming services contract opportunity at 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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