Sample Certificate of Liability Insurance~75.pdf

This is a Sample Certificate of Liability Insurance document provided by the Illinois Department of Natural Resources (IDNR) for use in connection with the Rice Lake State Fish and Wildlife Area Farm Lease (Contract 27AL2377). The document serves as a template for contractors to demonstrate required insurance coverage and is intended for informational purposes only. The certificate requires contractors to list three separate insurance policies with their respective policy numbers, start dates, and end dates. Key requirements include designating IDNR as an additional insured on the certificate and meeting minimum coverage amounts as required by law and specified in the contract terms.

The document emphasizes that contractors must complete all required fields, including affirmative or negative responses to coverage questions, even when certain coverages do not apply. The certificate specifies minimum contract requirements for additional coverage and information, which may exceed statutory minimums. The document explicitly notes that it does not supersede any requirements in the executed farm lease agreement and that the contractual terms of the actual lease between the tenant farmer and IDNR control all obligations. This template is designed to ensure contractors maintain adequate liability insurance protection throughout the term of the agricultural farming services on state-owned property.