Liability Insurance Form Sample
Liability Insurance Requirements - You are encouraged to give this to your homeowners agent AFTER booking for your event.
Four things that must be on the insurance certificate -
1. $1,000,000 limit of liability insurance coverage
2. $5000 limit of medical payments coverage
3. City of Humphrey, PO Box 486, Humphrey NE 68642 must be listed as a Certificate holder
4. City of Humphrey must be listed as an additional insured for the dates of your rental contract.
If your homeowners insurance policy will not extend coverage .. you must provide the city with a special events policy with the above information.
No exceptions - a phone call from your agent will not change the requirement. Please check with your agent months ahead of time. Waiting until 6 weeks before the wedding may not give you enough time to comply.




