TOCR Sample Certificate of Insurance.pdf
PDF 916 KB Posted
- Solicitation number
- PR-RFP 04012025
- Issued by
- Douglas County, Colorado
About this file
The document is a Contractor/Consultant Certificate of Insurance template from the Town of Castle Rock, Colorado, providing detailed instructions for insurance documentation requirements for contractors and consultants. The template specifies mandatory insurance certificate guidelines, including the need for policy limits to match or exceed contract requirements, policy start dates to precede the contract effective date, and specific additional insured language that must be included verbatim: "As required by written contract, the Town of Castle Rock, its Elected and Appointed Officials, Employees and Volunteers are included as Additional Insured."
The certificate template emphasizes strict compliance with insurance documentation, warning that failure to meet requirements may result in the Town moving to another contractor or consultant. It allows for additional insurance types like Cyber Liability and Professional Liability to be listed, and provides clear instructions about what can and cannot be added to the certificate. The document is specifically tailored for municipal contracting purposes and includes a specimen ACORD certificate with annotation points to guide contractors in completing the required insurance documentation accurately.
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Text version
Town of Castle Rock Contractor/Consultant
Certificate of Insurance Contractors/Consultants, please provide this sample certificate to your insurance agent or broker. Certificates must mirror this sample.
Note the Additional Insured special instructions below
Policy limits must be same or greater than required in the contract
Policy start date must be prior to effective date of the contract
Contractor/ Consultant's Legal Name
Types of insurance required in contract
If other insurance (Cyber Liability, Professional Liability, for example) is required, please list it here
Additional insured language in this box*
Verify correct address & contact information
*The Additional Insured language must state “As required by written contract, the Town of Castle Rock, its Elected and Appointed Officials, Employees and Volunteers are included as Additional Insured” with regards to the appropriate policies ONLY.
Project/contract detail such as the contract name and number can be added to the description box.
Qualifying language such as "subject to the terms and conditions of this policy" and "if required per written contract" CANNOT BE ADDED.
DO NOT attach additional insured endorsements or policies.
If the requirements cannot be complied with, the Town reserves the option to move on to another contractor/ consultant.
Town of Castle Rock A Colorado Municipal Corporation 100 N. Wilcox St.
Castle Rock, CO 80104
Cyber Liability, Information Security, Privacy Liability, Network Security, Cyber Security
TOCR rev. 08/2023
File details come from the government source that posted it. Updated .