Sample_Insurance_Certificate.pdf

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Attached to
Countertops for Housing Apartments
Solicitation number
CS-2026-QQ-01
Issued by
Broward County, Florida

About this file

This is a sample insurance certificate document related to a quartz countertop supply and installation bid solicitation issued by the City of Pembroke Pines, Florida. The City is requesting bids to supply and install quartz countertops for housing apartments on an as-needed basis across two residential complexes: Pines Point Residences (28 apartments at two locations: 401 N.W. 103 Avenue and 601 N.W. 103 Avenue) and Pines Place Residences (68 apartments across three addresses: 8103 S. Palm Drive, 8210 Florida Drive, and 8203 S. Palm Drive), all in Pembroke Pines, Florida. Bids are due July 8, 2026. The solicitation requires bidders to provide proof of insurance using the sample certificate format provided in this document. No specific contract term, renewal options, or award date is identified in the available materials.

The project is subject to HUD Section 3 requirements and Davis-Bacon prevailing-wage standards, as outlined in the related solicitation documents. Contractors must comply with applicable labor standards and execute a standard lien-release instrument upon project completion. The specimen construction agreement governs contractual relationships and performance terms. No specific contract value, evaluation criteria, incumbent vendor information, or funding sources are stated in the source materials. All required forms, wage determinations, technical specifications, and housing plans are available in the attached solicitation documents.

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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 .