(1) The Department shall adopt and use a Certificate of Coverage form indicating the insured agency and the coverage provided by the Fund.
    (2) Form DFS-D0-867, “State Employee Workers’ Compensation and Employer’s Liability Certificate of Coverage,” rev. 8/09, which is hereby adopted and incorporated by reference, will be used to provide employee workers’ compensation and employer’s liability coverage to the agency named on the certificate.
    (3) Form DFS-D0-863, “General Liability Certificate of Coverage,” rev. 11/05, which is hereby adopted and incorporated by reference, will be used to provide general liability insurance coverage to the agency named on the certificate.
    (4) Form DFS-D0-864, “Fleet Automobile Liability Certificate of Coverage,” rev. 11/05, which is hereby adopted and incorporated by reference, will be used to provide fleet automobile liability coverage to the agency named on the certificate.
    (5) Form DFS-D0-864A, “State Risk Management Trust Fund Addendum to Automobile Liability Certificate of Coverage for Off-Duty Law Enforcement Vehicle Property Damage,” rev. 11/05, which is hereby adopted and incorporated by reference, will be used to provide addendum to automobile liability coverage to the agency named on the certificate.
    (6) Form DFS-D0-865, “Federal Civil Rights Liability and Employment Discrimination Certificate of Coverage,” rev. 11/05, which is hereby adopted and incorporated by reference, will be used to provide coverage for federal civil rights actions under 42 U.S.C.S. 1983 or similar federal statutes to the agency named on the certificate.
    (7) Form DFS-D0-862, “Court Awarded Attorney Fees Certificate of Coverage,” rev. 11/05, which is hereby adopted and incorporated by reference, will be used to provide coverage for court awarded attorney’s fees in other proceedings against the agency named on the certificate.
    (8) Copies of these forms are available from the Division of Risk Management, Department of Financial Services, 200 East Gaines Street, Tallahassee, FL 32399-0337, (850)413-4852.
Rulemaking Authority 284.311, 284.39 FS. Law Implemented 284.30, 284.31 FS. History—New 7-29-72, Formerly 4-30.05, 4-30.005, Amended 1-7-92, 6-28-01, Formerly 4H-2.004, Amended 5-4-05, 7-23-06.