5 Colo. Code Regs. § 1002-66-F
Wording for Insurance Certificate
The standard insurance industry certificate of insurance form (ACORD form), as prescribed by the Colorado Insurance Commission, shall be used to evidence coverage for closure, post-closure, and corrective action costs for the permittee or applicant. The following information is to be included in the certificate of insurance:
(1) Name, address, and telephone number of agency; and the underwriter.
(2) Name of facilities being covered (if list is too long additional pages may be attached).
(3) Indication of type of coverage (closure, post-closure and corrective actions).
(4) Amount of coverage (closure costs or closure, post-closure and/or corrective action).
(5) A statement of certification, in the comment section, worded as follows:
"This certificate certifies that the policy to which this certificate applies, provides coverage for closure, post-closure, and/or closure action in connection with the insured's obligation to demonstrate financial assurance under section 61.13 of 5 CCR 1002-61, as amended (Colorado Discharge Permit System Regulations).
(6) A statement indicating that the insurer waives all rights of set off or liens against the policy.
(7) A statement indicating that the policy will not be cancelled by the insurer unless 90 days prior written notice is given to the Division.
(8) Authorized company representatives' signature.
5 CCR 1002-66-F