Sample Certificate of Liability Insurance~76.pdf

This is a Sample Certificate of Liability Insurance document for the Illinois Department of Natural Resources (IDNR) related to the Shabbona Lake State Park Farm Lease contract opportunity (27AL2032). The certificate template is designed to document insurance coverage for agricultural farming services on state-owned property. The form requires completion of policy information including policy numbers, start dates, and end dates for multiple coverage types. The document emphasizes that all required fields must be completed, even when the response is negative, and that IDNR must be listed as an additional insured on the policy.

The certificate specifies minimum insurance amounts required by applicable law and includes contractual requirements that may necessitate additional coverage beyond statutory minimums. Importantly, the document contains a disclaimer stating that it is for informational purposes only and does not supersede the terms of any executed farm lease between the tenant farmer and IDNR. The contractual terms of the actual executed farm lease agreement control all requirements and obligations between the parties.