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    Certificate of Liability Insurance Template

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    Liability insurance protects one from financial obstacles resulting from accidents or injuries in workplaces, such instances where such was caused by an employee. A certificate of liability insurance serves as proof of the insurance coverage of the one insured.

    This Certificate of Liability Insurance PDF Template provides comprehensive information as proof of coverage for the named insured for the certificate producer's or issuer's use. Part of the insurance certificate's value is that it contains extensive details about an insurance policy such as the types and limits of coverage, the name of issuing insurance company, policy number, the name of the insured, and the policy’s period or date of effectivity.
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    Certificate of Liability Insurance Template
    100%
    Certificate of Liability Insurance Template
    Date
    31/12/2018
    Producer
    Suspendisse
    Contact Person
    Jasmin Tutchings
    Phone Number ☎
    (78) 3954860
    98 Daystar Junct
    Richmond, Vi, 23220
    Insurers Affording Coverage
    NameNAIC No.
    Insurer ACountry Mutual Insurance Company20990
    Insurer B
    Insurer C
    Insured
    Suspendisse ornare consequat lectus. In e
    294 Blackbird Circle
    Albany, Ne
    Coverages
    Limits
    Type of Insurance
    General Liability
    Commercial General Liability
    Claims Made
    Occur
    Insr Ltr
    S
    Policy Number
    In est ri
    Each Occurrence
    1
    Damage to Rented Premises
    5
    Policy Effective Date
    August 4, 1984
    Medical Expense (Any Person)
    3
    Policy Expiration Date
    April 28, 2015
    General Aggregate Limit Applies Per
    Policy
    Project
    Location
    Personal and Advertising Injury
    3
    General Aggregate
    5
    Bodily Injury (Per accident)
    Insr Ltr
    D
    Automobile Liability
    Any Auto
    All owned Autos
    Scheduled Autos
    Hired Autos
    Non-owned Autos
    Combined Single Unit (ea accident)
    Policy Number
    In est ri
    Bodily Injury (Per person)
    Policy Effective Date
    April 4, 1995
    Property Damage (Per Accident)
    Policy Expiration Date
    April 28, 2015
    Certificate of Liability Insurance Template
    Date
    31/12/2018
    Garage Liability
    Limits
    Garage Liability
    Any Auto
    Insr Ltr
    Policy Number
    Auto Only - EA Accident
    Policy Effective Date
    Other than Auto Only (Agg)
    Other than Auto Only (ea acc)
    Policy Expiration Date
    Aggregate
    Insr Ltr
    I
    Excess/Umbrella Liability
    Occur
    Claims Made
    Deductible
    Retention
    Policy Number
    Suspendis
    Each Occurrence
    Policy Effective Date
    April 28, 2015
    Policy Expiration Date
    August 4, 1984
    Deductible amount
    Retention amount
    78914

    Workers compensation and employer's liability

    Insr Ltr
    Policy Number
    WC Statutory Limits
    Yes
    Policy Effective Date
    E.L. Each Accident
    1
    Policy Expiration Date
    E.L. Disease - Ea Employee
    5
    E.L. Disease - Policy Limit
    5
    Description of Details / Special Provisions
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    Certificate Holder Name
    Authorized Representative
    signature
    Certificate Holder Address
    Certificate of Liability Insurance Template

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