Sample_Insurance_Certificate.pdf
PDF 70 KB Posted
- Attached to
- Academic Village Cooling Tower
- Solicitation number
- PSPW-25-10
- Issued by
- Broward County, Florida
About this file
This document is an ACORD Certificate of Liability Insurance Sample template for a contract with the City of Pembroke Pines, Florida, specifically related to the Academic Village Cooling Tower project. The certificate serves as a standard insurance documentation form that requires the bidding company to provide general liability insurance coverage, with the City of Pembroke Pines named as the certificate holder and additionally insured. The template mandates specific insurance requirements, including the need to list the city's full address (601 City Center Way, Pembroke Pines, FL 33025) and include a statement that "THE CERTIFICATE HOLDER IS NAMED AS ADDITIONALLY INSURED WITH REGARD TO GENERAL LIABILITY".
The insurance certificate is part of the procurement documentation for a critical HVAC infrastructure replacement project at the Pembroke Pines Charter School Academic Village Campus. The project involves demolishing existing cooling towers that have reached the end of their useful life and installing new stainless-steel units to ensure continuous cooling, improve system efficiency, and provide reliable service. While the certificate itself does not specify exact pricing or funding sources, it represents a standard risk management requirement for contractors bidding on municipal infrastructure projects, ensuring that the city is protected through appropriate liability insurance coverage during the project's execution.
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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 .