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1. Insurance Provider Details: Full legal name, registration number, and contact information of the insurance company providing the workers' compensation coverage

2. Policyholder Information: Complete details of the employer/company including legal name, registration number (KvK), address, and primary business activity

3. Policy Information: Policy number, effective dates, and type of coverage provided

4. Coverage Statement: Declaration confirming that the policy meets the minimum requirements under Dutch law for workers' compensation insurance

5. Coverage Details: Specific information about what the policy covers, including types of injuries, illnesses, and maximum benefit amounts

6. Employee Classification: Categories of employees covered under the policy, including full-time, part-time, and temporary workers

7. Territorial Scope: Geographic areas where the coverage is valid, including any international coverage if applicable

8. Certification Statement: Official statement certifying the validity of the insurance coverage

9. Authorized Signature: Signature block for insurance company representative with authority to issue the certificate

1. Schedule A - Coverage Limits: Detailed breakdown of coverage limits for different types of claims and benefits

2. Schedule B - Premium Information: Details of premium calculations and payment schedules

3. Schedule C - Covered Locations: List of all business locations covered under the policy

4. Appendix 1 - Employee Categories: Detailed breakdown of employee classifications and corresponding coverage levels

5. Appendix 2 - Claims History: Summary of recent claims history if required for regulatory purposes