Sample_Insurance_Certificate.pdf

This document is an ACORD Certificate of Liability Insurance sample template for an insurance submission to the City of Pembroke Pines, Florida, related to a water storage tank exterior stripping and coating project. The certificate demonstrates the insurance requirements for contractors bidding on the project, specifically requiring general liability insurance with the City of Pembroke Pines named as an additional insured. The template provides a standardized format for insurance documentation, highlighting key coverage areas such as commercial general liability, with spaces for policy numbers, effective dates, and coverage limits.

The insurance certificate mandates that the contractor must provide comprehensive general liability coverage, with the City of Pembroke Pines listed as the certificate holder at 601 City Center Way, Pembroke Pines, FL 33025. The document emphasizes that the certificate must include specific wording stating "THE CERTIFICATE HOLDER IS NAMED AS ADDITIONALLY INSURED WITH REGARD TO GENERAL LIABILITY" and allows for multiple insurance providers to be listed. While this is a sample template, it represents a critical component of the bidding process for the water tank exterior coating project, ensuring that potential contractors demonstrate appropriate insurance protections before contract award.