Sample_Insurance_Certificate.pdf
PDF 70 KB Posted
- Attached to
- Used Tractor to pull Sewer Vacuum Trailer Pump
- Solicitation number
- PSUT-26-QQ-03
- Issued by
- Broward County, Florida
About this file
This is a Certificate of Insurance related to the City of Pembroke Pines' procurement of a used tractor truck with specific mechanical requirements. The document serves as proof of insurance coverage for a contractor bidding on or performing work related to the acquisition of a used tractor truck with a GVWR of 80,000 LBS equipped with a Cummins engine and PTO (Power Take-Off) for a wet line kit compatible with a sewer vacuum trailer. The certificate confirms that the contractor maintains active insurance policies meeting the city's requirements for this procurement.
The document appears to be a standard Certificate of Insurance form with fields for policy information, coverage types, coverage limits, and expiration dates. While the specific coverage amounts, policy numbers, and effective dates are not clearly legible in the provided image, this certificate would typically document general liability, workers' compensation, and any other required coverage as mandated by the City of Pembroke Pines for contractors engaged in equipment procurement or related services.
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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 .