Mississippi Administrative Code › Title 12 - Finance and Administration › Part 3 - Bureau of Building, Grounds and Real Property Management › Chapter 2 - Rules for the Bureau of Building, Grounds and Real Property Management › Rule 12-3-2.1 - Policies and Procedures › Division 12-3-2.1-0 - BIDDING AND CONTRACT REQUIREMENTS › Section 12-3-2.1-0-00650 - CERTIFICATE OF INSURANCE INSTRUCTIONS

Current through June 25, 2024
1. The
Certificate of Insurance
is a tabulation of insurance required
					 for this Project as specified in Article 11 entitled
Insurance and
					 Bonds
in the General Conditions (AIA Document A201, Sixteenth Edition,
					 2007).
2. The
Certificate
					 of Insurance
must be completed, certified by the original signature of
					 a Mississippi Licensed Insurance Agent and/or countersignature, dated, and
					 bound in each set of the Contract Documents. Insurance Companies providing
					 coverage and Agent and/or Countersignature Agent must be approved by the
					 Mississippi Insurance Department on their web at
http://www.mid.ms.gov/licapp/search_main.aspx
.
					 (Agent does not have to be on the MID web "for providers necessarily" but must
					 be an approved Agent on MID web. Easier to locate Agent at MID when name agrees
					 with MID licensed name.)
3.
					 Indicate Insured, Project, Companies providing coverage, policy numbers and
					 policy periods in the blanks as applicable.
4. If the "OWNERS/CONTRACTORS PROTECTIVE
					 LIABILITY" insurance is part of the Commercial General Liability Insurance
					 Policy, or included by endorsement, indicate the policy number and period of
					 the CGL policy in the "OWNERS/CONTRACTORS PROTECTIVE LIABILITY" blank
					 spaces.
5. Automobile Liability
					 Insurance may be provided which covers Bodily Injury and Property Damage in one
					 (1) Combined Single Limit, or may be provided with separate minimum limits as
					 shown on the Certificate of Insurance and specified in Article 11 of the
					 Supplementary Conditions. The person signing the Certificate of Insurance
					 should show which option the Contractor has selected by marking out the
					 coverage that is not provided under the policies indicated.
6. OTHER INSURANCE (if required) will be
					 indicated by typing in the "OTHER" block and detailed in Article 11 of the
					 Supplementary Conditions.
7.
					 CERTIFICATION wording may not be changed without specific written approval from
					 the Owner.
8. "Riders", Binders,
					 TBA, TBD, or other unsolicited attachments, are not allowed as part of the
Certificate of Insurance
unless specifically requested in
					 writing by the Owner, or specified as part of the requirements for this
					 Project.
9. CAUTION: The
Certificate of Insurance
is intended to be used for all
					 Projects. The Contractor must provide all insurance specified in the Contract
					 Documents for this Project, whether indicated on this form, or not. The
					 Contractor must verify all insurance has been provided as required.
10. In accepting the Insurance Certificate by
					 Owner, it would be helpful if some indication is given when, and if, the
					 Provider is a Surplus Line Carrier, a Broker, or Self Insured (because they may
					 not be on the MID web list referenced herein). (The Owner will have to ask MID
					 (or know) at some point.)