Sample_Insurance_Certificate.pdf

This document is an ACORD Certificate of Liability Insurance sample template for a contract opportunity with the City of Pembroke Pines, Florida, specifically related to the Water Treatment Plant Unit B Rehabilitation project. The sample certificate demonstrates the required insurance documentation that a contractor must submit, which includes General Liability insurance with the City of Pembroke Pines named as the Certificate Holder and Additional Insured. The template provides guidance on key insurance coverage requirements, such as including General Liability coverage and specific wording that must appear on the certificate.

The insurance certificate requires comprehensive liability coverage with specific instructions for completion, including naming multiple insurers, providing policy numbers, effective dates, and coverage limits. The document emphasizes that the certificate must explicitly state "THE CERTIFICATE HOLDER IS NAMED AS ADDITIONALLY INSURED WITH REGARD TO GENERAL LIABILITY" and list the City of Pembroke Pines at 601 City Center Way, Pembroke Pines, FL 33025 as the certificate holder. While this is a sample template, it provides a clear framework for the insurance documentation required for bidders on the Water Treatment Plant rehabilitation project.