Certificates

Our company understands that if you don’t have Certificates of Insurance and Additional Insured Endorsements, you may not get paid and/or may not be allowed on the job. These documents are important to your business! That is why we have a dedicated certificate department responsible for processing and issuing these requests everyday.

We have dedicated service representatives to handle your certificate and endorsement needs. Our team knows the importance of turning them around in a timely manner and making sure your certificate holders are satisfied and up to date.

Contracts – we provide contract review services. If required, we can provide outside legal counsel for an in depth contract interpretation.

Fill out our the request form below or call us 800-400-6394, ext 137

 

PLEASE ISSUE A CERTIFICATE OF INSURANCE TO: (COMPLETE ADDRESS REQUIRED TO ISSUE):

Insured Business Name:

Certificate Holder Name:

Your Email:

Date :

Address:

City:

State:

Zip:

Project Owner (If different from above):

ABOVE IS THE FOLLOWING TYPE OF ENTITY:

General ContractorSub ContractorOwner VendorLandlordOther

Additional Insured:YesNo

Waiver of Subrogation (General Liability): YesNo

Waiver of Subrogation (Workers Compensation): YesNo

Job Involved in Wrap-up/OCIP/CCIP Insurance Program: YesNo

JOB INFORMATION:

*Required for all Additional Insured requests. Additional Insured Endorsements, Waivers of Subrogation, Primary Wording & other special requests are subject to additional premium & will need to be approved by the Insurance Company. These requests may require a longer turnaround time.

Job Name:
Job Address(s):
Job Project #:
Job value:

Start date (mm/dd/yyyy):
Completion Date (mm/dd/yyyy):

Job Description (Type of Work You are Performing - Please be Specific)

*NOTE: "All Operations" and "All California Operations" are unacceptable as job descriptions.

Send Certificate By:
FaxEmail

*DUE TO CURRENT MARKET CONDITIONS SOME OF THESE REQUESTS MAY NOT BE AVAILABLE. PLEASE CHECK WITH OUR CERTIFICATE DEPARTMENT PRIOR TO SIGNING CONTRACTS THAT MAY REQUIRE THE FOLLOWING: FORM 2010 11/85, PER PROJECT AGGREGATE, PRIMARY WORDING, ETC.

Please attach contract insurance requirements