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. The certificate provides guidance for insurance providers on how to complete a liability insurance certificate for a contract, specifically highlighting requirements for general liability coverage. The template mandates that the City of Pembroke Pines must be named as the certificate holder, with the specific address listed as 601 City Center Way, Pembroke Pines, FL 33025.

The sample certificate emphasizes key insurance requirements, including the necessity of general liability coverage and a specific wording that states "THE CERTIFICATE HOLDER IS NAMED AS ADDITIONALLY INSURED WITH REGARD TO GENERAL LIABILITY". The document is designed to ensure that any contractor providing services to the City of Pembroke Pines has appropriate insurance coverage, with spaces for multiple insurers, policy numbers, effective dates, and coverage limits across various liability categories such as commercial general liability, automobile liability, and workers' compensation.