Storage Tank Certificate of Insurance

Form 62-761.900(3) Part D

Other Forms Needed, Examples, and Links

• Form Part P (Certification of Financial Responsibility) 
• Signed copy of policy with all amendments and endorsements
• Insurance Checklist
• Example Facility/Tank Schedule
• Links to Outside Agencies - for verifications (Sunbiz, Insurance)

Insurance Specific Guidance

• ACORD form may not be used as proof of financial responsibility
• Verify date of witness signature is reasonable (either after the start of the period of coverage or shortly before it started).

What to Do with Completed Forms

• An owner or operator must maintain financial responsibility records (the completed form parts with required supporting documentation) at the facility or at their business office.
• If not kept at the facility, they shall be made available at the facility or another agreed upon location upon five business days notice by a department or county inspector.

Return to Storage Tank Financial Assurance Forms (Mechanisms) webpage.