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9/7/2008
terms and conditions

We realize that Certificates are an integral part of your insurance needs, and we recognize the importance of working on your schedule. It is a pleasure for us to receive your Certificate requests at any hour and give you the sense of ease knowing we have processed your request.

Name of Insured:
Policy Term Requested:
Name of Holder
(person/business requesting certificate):
Street:
City:
State:
Zip Code:
E-Mail Address:
Phone:
Fax Number:
List Specific Job (if needed):
Does the holder need to be listed
as named insured?		 yes
no
Other/Comments:

To make certain your requests are correctly and promptly processed, there are several simple things you can do.

  1. Be sure to send us your request at least 2 hours prior to your deadline.
  2. Make certain we always have either an email address or fax number for the Certificate Holder.
  3. Provide all special requirements or endorsements required. If you have any question on the requirements, please email or fax us a copy of applicable contracts and we will review them for you.
  4. Please remember that we can not change, alter, amend or add coverage to your policy, simply by issuing a certificate of insurance. It would be a grave violation of the state insurance law.