Sample Certificate of Liability Insurance~78.pdf

PDF 812 KB Posted

Attached to
27AL2395 Iroquois County SFWA Farm Lease
Solicitation number
27-422DNR-REALT-B-54118
Issued by
Grundy County, 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 27AL2395 Iroquois County State Fish & Wildlife Area (SFWA) Farm Lease contract opportunity. The certificate template outlines insurance requirements that contractors must maintain throughout the contract period. The document requires contractors to list multiple policies with their respective policy numbers, start dates, and end dates. The template includes specific notation requirements, including that all applicable boxes must be completed regardless of whether certain coverage applies, and that the IDNR must be listed as an additional insured on the certificate.

The certificate of liability insurance serves as proof of minimum insurance coverage mandated by law and contractual requirements for the farm lease agreement. The document emphasizes that it is for informational purposes only and does not supersede the actual requirements specified in any executed farm lease agreement. Contractors must comply with both the minimum amounts required by applicable law and any additional minimum contract requirements outlined in their specific lease terms. The certificate represents a standard risk management requirement to ensure contractors maintain adequate liability protection during the performance of agricultural farming services on state-owned property.

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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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