Sample_Insurance_Certificate.pdf

PDF 70 KB Posted

Attached to
July 4th Fireworks
Solicitation number
RE-26-QQ-03
Issued by
Broward County, Florida

About this file

Sample Insurance Certificate Summary

This is an insurance certificate document related to the City of Pembroke Pines' July 4th Fireworks display procurement in Florida. The certificate appears to be a standard Certificate of Insurance template designed to document the required insurance coverage that contractors must maintain prior to commencing work on this project. The document includes fields for policy information, coverage types, and coverage limits, formatted in a typical insurance certificate layout with sections for general liability, workers' compensation, and additional insured parties. While the specific policy details are not legible in the provided image, the certificate serves as proof that the selected contractor has obtained the mandatory insurance coverage outlined in the solicitation requirements.

The insurance requirements for this fireworks display contract are substantial and must be verified through submission of a completed certificate prior to work commencement. Contractors are required to maintain Comprehensive General Liability coverage of $1,000,000 per occurrence with a $2,000,000 general aggregate, statutory Workers' Compensation insurance, Comprehensive Auto Liability of $1,000,000 combined single limit, Umbrella/Excess Liability coverage of $2,000,000, and Environmental/Pollution Liability of $1,000,000. The City of Pembroke Pines must be named as an additional insured party on all applicable policies. No performance bonds or proposal security are required for this procurement. The fixed contract award is $35,000 all-inclusive with no additional charges permitted, and contractors must obtain all required permits at least 30 days prior to the July 4th, 2026 event while submitting a detailed operational plan two weeks before the scheduled display.

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YOUR COMPANY NAME HERE Companies providing coverage

SAMPLE CERTIFICATE

Must Include General Liability

City of Pembroke Pines 601 City Center Way Pembroke Pines FL 33025

City Must Be Named as Certificate Holder

"THE CERTIFICATE HOLDER IS NAMED AS ADDITIONALLY INSURED WITH REGARD TO GENERAL LIABILITY"

Certificate must contain wording similar to what appears below

File details come from the government source that posted it. Updated .