The Texas 1560 form is a Certificate of Insurance that provides essential information regarding insurance coverage for contractors working with the Texas Department of Transportation (TxDOT). This form ensures that the required insurance policies are in effect and serves as proof of compliance with TxDOT’s insurance requirements. To get started on filling out the Texas 1560 form, please click the button below.
When filling out the Texas 1560 form, it is essential to follow specific guidelines to ensure accuracy and compliance. Below is a list of things you should and shouldn't do:
Following these guidelines will help ensure that your submission is processed smoothly and without delays. If you have any questions or need further clarification, it is advisable to reach out for assistance.
CERTIFICATE OF INSURANCE
Form 1560 (Rev. 01/12)
Previous editions of this form may not be used. Page 1 of 2
Agents should complete the form providing all requested information then either fax or mail this form directly to the address listed on page two of this form. Copies of endorsements listed below are not required as attachments to this certificate.
This certificate is issued as a matter of information only and confers no rights upon the certificate holder. This certificate does not confer any rights or obligations other than the rights and obligations conveyed by the policies referenced on this certificate. The terms of the policies referenced in this certificate control over the terms of the certificate.
Insured:
Street/Mailing Address:
City/State/Zip:
Phone Number: (
)
-
WORKERS' COMPENSATION INSURANCE COVERAGE:
Endorsed with a Waiver of Subrogation in favor of TxDOT.
Carrier Name:
Carrier Phone #: (
Address:
City, State, Zip:
Type of Insurance
Policy Number
Effective Date
Expiration Date
Limits of Liability:
Workers' Compensation
Not Less Than: Statutory - Texas
COMMERCIAL GENERAL LIABILITY INSURANCE:
Type of Insurance:
Policy Number:
Effective Date:
Expiration Date:
Commercial General
Not Less Than:
Liability Insurance
$ 600,000 each occurrence
BUSINESS AUTOMOBILE POLICY:
Business Automobile Policy
$ 600,000 combined single limit
Bodily Injury
Property Damage
UMBRELLA POLICY (if applicable):
Umbrella Policy
Should any of the above described policies be cancelled before the expiration date thereof, notice will be delivered in accordance with the policy provisions.
THIS IS TO CERTIFY to the Texas Department of Transportation acting on behalf of the State of Texas that the insurance policies named are in full force and effect. If this form is sent by facsimile machine (fax), the sender adopts the document received by TxDOT as a duplicate original and adopts the signature produced by the receiving fax machine as the sender's original signature.
Agency Name
Address
City, State, Zip Code
(
Authorized Agent's Phone Number
Authorized Agent Original Signature
Date
The Texas Department of Transportation maintains the information collected through this form. With few exceptions, you are entitled on request to be informed about the information that we collect about you. Under §§552.021 and 552.023 of the Texas Government Code, you also are entitled to receive and review the information. Under §559.004 of the Government Code, you are also entitled to have us correct information about you that is incorrect.
Fax completed form to: 512/416-2536
Form 1560 (Rev. 01/12) Page 2 of 2
NOTES TO AGENTS:
Agents must provide all requested information then either fax or mail this form directly to the address listed below.
Pre-printed limits are the minimum required; if higher limits are provided by the policy, enter the higher limit amount and strike-through or cross-out the pre-printed limit.
To avoid work suspension, an updated insurance form must reach the address listed below one business day prior to the expiration date. Insurance must be in force in order to perform any work.
Binder numbers are not acceptable for policy numbers.
The certificate of insurance, once on file with the department, is adequate for subsequent department contracts provided adequate coverage is still in effect. Do not refer to specific projects/contracts on this form.
List the contractor's legal company name, including the DBA (doing business as) name as the insured. If a staff leasing service is providing insurance to the contractor/client company, list the staff leasing service as the insured and show the contractor/client company in parenthesis.
The TxDOT certificate of insurance form is the only acceptable proof of insurance for department contracts.
List the contractor's legal company name, including the DBA (doing business as) name as the insured or list both the contractor and staff leasing service as insured when a staff leasing service is providing insurance.
Over-stamping and/or over-typing entries on the certificate of insurance are not acceptable if such entries change the provisions of the certificate in any manner.
This form may be reproduced.
DO NOT COMPLETE THIS FORM UNLESS THE WORKERS' COMPENSATION POLICY IS ENDORSED WITH A WAIVER OF SUBROGATION IN FAVOR OF TXDOT.
The SIGNATURE of the agent is required.
CERTIFICATE OF INSURANCE REQUIREMENTS:
WORKERS' COMPENSATION INSURANCE:
The contractor is required to have Workers' Compensation Insurance if the contractor has any employees including relatives.
The word STATUTORY, under limits of liability, means that the insurer would pay benefits allowed under the Texas Workers' Compensation Law.
GROUP HEALTH or ACCIDENT INSURANCE is not an acceptable substitute for Workers' Compensation.
MANUFACTURERS' or CONTRACTOR LIABILITY INSURANCE is not an acceptable substitute for Comprehensive General Liability Insurance or Commercial General Liability Insurance.
If coverages are specified separately, they must be at least these amounts:
$500,000 each occurrence
$100,000 each occurrence
$100,000 for aggregate
PRIVATE AUTOMOBILE LIABILITY INSURANCE is not an acceptable substitute for a Business Automobile Policy.
MAIL ALL CERTIFICATES TO:
Texas Department of Transportation
CST Contract Processing Unit (RA/200 1st Fl.) 125 E. 11th Street
Austin, TX 78701-2483 512/416-2540 (Voice), 512/416-2536 (Fax)
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The Texas 1560 form, also known as the Certificate of Insurance, is a crucial document that provides proof of insurance coverage for contractors working with the Texas Department of Transportation (TxDOT). Alongside this form, several other documents are often required to ensure compliance with state regulations and to protect all parties involved. Below is a list of documents commonly used in conjunction with the Texas 1560 form.
These documents collectively contribute to a comprehensive understanding of the insurance landscape for contractors working with TxDOT. They help ensure that all parties are adequately protected and that contractual obligations are met. Proper management of these forms is essential for maintaining compliance and safeguarding against potential liabilities.
Filling out the Texas 1560 form can be straightforward, but many people make common mistakes that can lead to delays or complications. One frequent error is failing to provide the correct insured name. The insured's legal company name must be listed, including any DBA (doing business as) names. Omitting this detail can result in the form being rejected.
Another common mistake is not including the complete contact information for the insurance carriers. Each carrier's name, phone number, and address must be fully detailed. Incomplete information can cause confusion and may lead to the form being considered invalid.
People often forget to indicate the effective and expiration dates of the insurance policies. These dates are crucial, as they confirm that the coverage is active and will remain so throughout the contract period. Missing these dates can lead to unnecessary work stoppages.
Some individuals mistakenly use binder numbers instead of actual policy numbers. Binder numbers are not acceptable on this form. Always ensure that the actual policy number is provided to avoid complications with the insurance verification process.
Additionally, many fail to strike through or cross out the pre-printed limits on the form when higher limits apply. If the policy provides coverage above the stated minimums, it is essential to indicate this correctly. Otherwise, the form may not meet the required standards.
Another mistake involves the signature of the agent. This signature is mandatory. Without it, the form is incomplete and will not be processed. Agents should double-check that their signature is present before submission.
People also often neglect to confirm that the Workers' Compensation policy includes a waiver of subrogation in favor of TxDOT. This endorsement is necessary for compliance, and failing to include it can lead to rejection of the form.
Some individuals mistakenly include over-stamped or over-typed entries that change the provisions of the certificate. Such alterations are not acceptable. The form must be filled out clearly and accurately without any modifications that could alter its meaning.
Lastly, many overlook the requirement to submit the form one business day prior to the expiration date of the insurance. This deadline is critical to ensure that there is no lapse in coverage and that work can continue without interruption.
Understanding the Texas 1560 form can be challenging due to several misconceptions. Here are six common misunderstandings:
When filling out and using the Texas 1560 form, it is essential to follow specific guidelines to ensure compliance with the Texas Department of Transportation (TxDOT) requirements. Here are some key takeaways:
By adhering to these guidelines, agents can facilitate a smoother process for obtaining and maintaining the necessary insurance coverage for TxDOT contracts.
Completing the Texas 1560 form requires careful attention to detail. After filling out the form, it must be sent directly to the Texas Department of Transportation. Ensure all necessary information is accurate and complete to avoid any delays in processing.