Sample Certificate of Liability Insurance~81.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 Moraine View State Park Farm Lease opportunity. The certificate serves as a template for contractors to document their insurance coverage and comply with the contractual insurance requirements established by IDNR. The document requires completion of multiple policy information fields, including policy numbers, start dates, and end dates for liability coverage. The certificate must be completed in its entirety, regardless of whether certain coverage requirements apply.

The certificate mandates that IDNR be listed as an additional insured on the liability policy and requires minimum coverage amounts as specified by contract terms and applicable law. The document includes notation that these insurance requirements represent the minimum contract requirements, though additional coverage or information may be included as needed. Importantly, the certificate is explicitly stated to be for informational purposes only and does not supersede the requirements of any executed farm lease agreement, with the actual contractual terms between the tenant farmer and IDNR controlling all obligations and requirements.