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Statement of Insurance If insured, please complete this section I, from (full name) (company, farm, etc.) hereby confirm that I have personal injury insurance and commercial general liability of a
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How to fill out cityhall-3022945-v1-sfamstatementofinsurance-1-rev1doc:

01
Begin by gathering all necessary information, such as the insured's name, address, and contact details.
02
Identify the policy number and effective dates of the insurance.
03
Review the required details of coverage, including liability limits and any additional endorsements.
04
Fill in the specific details of the insured property or item being covered.
05
Provide any additional information or documentation as requested by the form.
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Read through the completed form carefully to ensure all information is accurate and complete.
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Who needs cityhall-3022945-v1-sfamstatementofinsurance-1-rev1doc:

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Individuals or businesses who require proof of insurance coverage.
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It is a statement of insurance document related to City Hall activities.
All vendors and contractors working with City Hall are required to file this document.
The document must be filled out with detailed information about the insurance coverage of the vendor or contractor.
The purpose is to ensure that vendors and contractors have adequate insurance coverage for their work with City Hall.
Information such as insurance policy details, coverage amounts, and expiration dates must be reported.
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