CERTIFICATE OF INSURANCE FOR CLOSURE OR POST-CLOSURE CARE
Name and Address of Insurer (herein called the Insurer"): ____________________________________________
Name and Address of Insured (herein called the "Insured"): __________________________________________
Facilities Covered: [List for each facility: Name, address, and the amount of insurance for closure and/or the amount for post-closure care (these amounts for all facilities covered must total the face amount shown below).]
Face Amount:_______________________
Policy Number:______________________
Effective Date:_______________________
The Insurer hereby certifies that it has issued to the Insured the policy of insurance identified above to provide financial assurance for [insert "closure" or "closure and post-closure care" or "post-closure care"] for the facilities identified above. The Insurer further warrants that such policy conforms in all respects with the requirements of the Delaware Regulations Governing Solid Waste Section 4.1.11, as applicable and as such regulations were constituted on the date shown immediately below. It is agreed that any provision of the policy inconsistent with such regulations is herby amended to eliminate such inconsistency.
The Insurer further certifies the following with respect to the insurance:
I hereby certify that the wording of this instrument is identical to the wording in Appendix D and that the "Insurer" is licensed to transact the business of insurance, or eligible to provide insurance as an excess or surplus line insurer, in one or more States.
_____________________________________
Date
______________________________________
Signature of authorized representative of Insurer
______________________________________
Name of authorized representative
_______________________________________
Title of authorized representative
_______________________________________
Address of authorized representative
Del. Admin. Code tit. 7, 1000, 1300, 1301, app D to Section 4.1.11