Sample_Insurance_Certificate.pdf

PDF 70 KB Posted

Attached to
Wastewater Treatment Plant Unit 1 Rehabilitation
Solicitation number
PSUT-25-07
Issued by
Broward County, Florida

About this file

This document is an ACORD Certificate of Liability Insurance sample template for the City of Pembroke Pines, Florida, specifically related to the Wastewater Treatment Plant Unit 1 Rehabilitation project. The certificate provides a standard insurance documentation format that contractors must complete, requiring general liability coverage with the City of Pembroke Pines named as the certificate holder and additionally insured. The template outlines specific insurance requirements, including spaces for policy details such as policy numbers, effective dates, expiration dates, and coverage limits across various insurance categories like general liability, automobile liability, and workers' compensation.

The certificate emphasizes key compliance requirements for contractors, including mandatory general liability coverage and specific wording that names the City of Pembroke Pines as an additional insured. The sample document serves as a guide for potential bidders on the wastewater treatment plant rehabilitation project, indicating the city's insurance and risk management expectations for contractors. While the document does not provide specific pricing or financial details, it represents a critical administrative requirement for vendors seeking to participate in the municipal contract opportunity.

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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 .