Certificate of Insurance Forms

Individuals and organizations who supply goods and services to the City of Richmond Hill or who use City facilities are requested to provide evidence of insurance as part of the terms and conditions of the contract, purchase order, permit, license, or other form of agreement.

Evidence of insurance will only be accepted on a City of Richmond Hill Certificate Form, which must be completed by an insurance broker or authorized representative of the Insuring Company and signed by the Insuring Company. The Insurance Broker signature will be accepted if the Broker provides a letter or email from the insurer indicating that the broker has been authorized to sign on behalf of the insurance company. Please refer to Number 1 below for Special Instructions for Insurance Brokers. 

Below are links to the City standard insurance certificate forms in fillable format. 

1. Special Instructions for Insurance Brokers
   These instructions will assist Insurance Brokers in completing the required forms accurately.
2. General Liability - Standard Form
   This form is used for agreements, permits, leases, licenses, and other activities or programs where proof of liability insurance is required.
3. General Liability - Facility Rentals
   This form is used to provide evidence of liability insurance for low risk community special events and facility rentals. Vendors considered “high risk” - for example, supplier of carnival rides, displays involving animals, and fireworks - must provide evidence on the General Liability - Standard Form.
4. Automobile Liability
   This form is required for any contract, project, or service where a licensed vehicle is used in the performance or delivery of the service.
5. Umbrella or Excess Liability
   This form is used to provide evidence of additional limits of liability coverage in excess of the primary General Liability or Automobile Liability Insurance policy. The required limit of coverage may be achieved by combining the General Liability and Umbrella Limits of Liability.
6. Construction Liability
   This form is used for projects related to infrastructure design, and all construction project work within the City of Richmond Hill.  Construction work includes large building renovations, new build, sidewalk and road repair contracts, parks, subdivisions, etc.
7. Course of Construction Property - Builders Risk
   This certificate is used when evidence of All Risk Property Insurance is required for a construction project; may include large building renovations, new build, sidewalk and road repair contracts, parks, subdivisions, etc.         
8. Property Insurance Coverage
   This certificate is used when evidence of Property, Equipment and Machinery insurance is required for City-owned or private property.    
9. Pollution/Environmental Impairment Liability
   This certificate is completed when any City agreement stipulates that evidence of Pollution or Environmental Impairment Liability is required.
10. Professional/Errors and Omissions Liability
    This form is for consultants or other professionals undertaking work for the City which is considered "professional" in nature, such as geotechnical, engineering, design or architectural work, as well as specialty consultations.
11. Cyber/Network Liability
    This form is for IT Professional Consulting and Technology Services that could potentially expose the City of Richmond Hill to a cyber or network breach of protected data governed by the Privacy Commission.
12. Crime Insurance Coverage
    This form is for suppliers or contractors that may handle money or currency of any kind or are required to provide evidence that their Employee(s) are bonded due to the handling of money and securities on behalf of the City.
13. Garage Keepers Liability
    This form is required by suppliers/vendors who complete repairs or maintenance on City Owned Vehicles and Equipment on their property. Example:  A City Vehicle is being housed at a Garage in order to complete required repairs to the City Vehicle.

If you have any questions regarding completion of these certificates, please contact the Risk and Insurance Section at risk.management@richmondhill.ca or by phone at 905-771-2487 or 905-747-6518.