Sample Certificate of Liability Insurance~82.pdf
PDF 812 KB Posted
- Solicitation number
- 27-422DNR-REALT-B-54198
- 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 Sanganois State Fish and Wildlife Area Farm Lease (27AL2192). The document serves as a template for contractors to demonstrate proof of liability coverage and specifies the insurance requirements that must be maintained throughout the contract term. The certificate requires documentation of policy numbers, start dates, and end dates across multiple coverage lines, with specific notation that all fields must be completed regardless of applicability. The IDNR must be listed as an additional insured on the liability policy to ensure protection for the state agency overseeing the agricultural operations on state-owned property.
The document establishes minimum insurance coverage amounts required by law and contract, with additional provisions that may be included depending on specific lease requirements. A critical notation indicates that this certificate is intended for informational purposes only and does not supersede the requirements outlined in any executed farm lease agreement. The contractual terms and insurance obligations specified in the executed farm lease between the tenant farmer and IDNR control over and above the requirements shown in this sample document. Bidders responding to this opportunity must ensure compliance with all insurance requirements detailed in the formal Invitation for Bid (IFB) and any subsequent lease agreement.
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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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