Sample Certificate of Liability Form

This is the standard industry form (click here for .pdf version) needed from each tenant. SmallOffices4Rent.com and building owner and/or building management must be "Scheduled" and listed as "Additionally Insured" on the General Liability policy. See Section 5 of our leasing agreement for details.

1. Producer: Tenant's insurance company/agent
2. Insured: Must be same name as listed on leasing document
3. Expiration Date: New certificates needed annually as they expire
4. General Liability: We need new certificates as these expire annually
5. Certificate Holder: SmallOffices4Rent.com and building owner/manager must be listed here and on policy as Additionally Insured