Certificate of Insurance Forms

Individuals and organizations who supply goods and services to the City or who use City facilities may be required to provide evidence of insurance as part of the terms and conditions of the contract, purchase order, permit, license or other forms of agreement.

Evidence of insurance will ONLY be accepted on a City of Richmond Hill Certificate of Insurance 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 confirmation that they have been authorized to sign on behalf of the insuring company. Please refer to Number 1 below - “Instructions for Insurance Brokers”.

Below are links to City standard insurance certificates in PDF fillable format.

1. Instructions for Insurance Brokers
   This is a step-by-step guide to assist Brokers in completing the required forms accurately.
2. Commercial General Liability – Standard Form
   This form is the standard CGL insurance form which can be used for all contracts, agreements, permits, leases, licenses, or programs where proof of liability insurance is required.
3. Construction – Commercial General Liability
   This form is used where construction is the focus of the services being delivered within the City of Richmond Hill. This includes large building renovations, new build, sidewalk and road repair contracts, infrastructure design, parks reconstruction, subdivisions, etc.
4. Excess or Umbrella Liability
   This form is used to provide evidence of additional limits of liability coverage in excess of the primary Commercial General Liability or Automobile Liability Insurance policy. The required limit of coverage may be achieved by combining the Primary Liability and Excess Limits of Liability.
5. Facility Rental Liability 
   This form is used to provide evidence of liability insurance for Community Special Events and City facility bookings and rentals.
6. Automobile Liability
   This certificate is required for any contract, project or service where a licensed vehicle is used in the performance or delivery of the service.
7. Property Insurance Coverage
   This certificate is used when evidence of Property, Equipment and Machinery insurance is required for City owned or private property.
8. Builders Risk or Course of Construction Property
   This certificate is used when evidence of All Risk Property Insurance is required for a construction project; may include large building renovations, new build, major sidewalk and road construction contracts, subdivisions, etc.
9. Pollution or Environmental Impairment Liability
   This certificate is only required when a City Contract or Agreement stipulates that evidence of Pollution or Environmental Impairment Liability is required.
10. Professional or 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, electrical, design or architectural work, IT specialists, as well as specialty technicians’ and consultants.
11. Cyber or Network Security Liability
    This form is only required when a City Contract or Agreement stipulates that evidence of Cyber or Network Security Liability insurance is required.  This will be required when the program, systems or services being delivered have the potential to give rise to a cyber or network breach of private, confidential, or protected data held by the City of Richmond Hill and governed by the Office of the Privacy Commissioner.
12. Crime Insurance
    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 Automobile Liability
    This form is required by suppliers or vendors who complete repairs or maintenance on City owned vehicles and equipment while on their private property.  Example: A City vehicle is being housed at a garage to complete required repair work.

Note: The above certificates were updated in September 2024

If you have any questions regarding completion of these certificates, contact the Risk and Insurance Section at risk.management@richmondhill.ca or at 905-771-8800, ext. 2543 or 905-747-6518 during regular business hours.