Sample_Insurance_Certificate.pdf
PDF 70 KB Posted
- Solicitation number
- PSUT-26-04
- Issued by
- Broward County, Florida
About this file
This is an insurance certificate of insurance document related to the City of Pembroke Pines' CDBG-MIT Waste Water Treatment Plant Emergency Power System Replacement project in Florida. The certificate appears to be a standard proof of insurance form used to document that a contractor maintains required insurance coverage for the project. The document contains fields for listing insurance carriers, policy numbers, coverage limits, and effective dates, though the specific details are not clearly legible in the provided image. The certificate is issued to verify that the contractor has obtained the necessary insurance policies to comply with the project requirements prior to commencing work on the generator replacement and installation activities at the Pembroke Pines Wastewater Treatment Plant.
The insurance certificate serves as documentation that the contractor meets the insurance requirements established by the City of Pembroke Pines for this public works project. As a CDBG-MIT funded initiative, the project likely requires standard commercial general liability, workers' compensation, and equipment insurance coverage. The certificate format and requirements would be specified in the bid documents and contract terms to ensure adequate protection for the municipality during the demolition, removal, installation, and restoration phases of the emergency power system replacement work at the wastewater treatment facility.
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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 .