Liability & Insurance

Sample Form 10: Certificate of Property Insurance 

Insured -Must include the name of our tenant.
Type of Insurance -Special Form means all losses are insured unless they are excluded.
Policy Effective Date -Dates must be current.
Policy Expiration Date -Dates must be current.
Limits -Tenants Improvements and Betterment are included in the Personal Property Limit.

Contact Information

Jamie Bloom, Insurance Manager

Katie MacKay, Liability Manager

Risk Management Division

Human Resources Department

Business Hours
Monday – Friday
8:00 AM – 5:00 PM
Contact us by Phone
575 Administration Drive
Room 116 B
Santa Rosa, CA 95403
38.465237, -122.725363

Sample Form

Property Insurance

Sample Form

Image of sample form with field definitions and explanations.