Certificate Of Insurance Form 2014

4 2 2014 11 56 23 am.

Certificate of insurance form 2014. The massachusetts division of insurance division has been informed however that. Certificate does not affirmatively or negatively amend extend or alter the coverage afforded by the policies below. Page 4 of 5 july 2014 complete the certificate of insurance with the information listed below. Per accident ea accident n a subr wvd addl insd.

The certificate does not affirmatively or negatively amend extend or alter the coverage afforded by the policies listed on the certificate. Request for certificate of insurance if you are an insured and need certificates of your insurance mailed to a certificate holder please fill out the form below and email it to us at. This certifies that policies of insurance as described below have been issued to the insured named below and are in full force and effect at this time. This certificate of insurance does not constitute a contract between the issuing insurer s authorized representative or producer and the certificate holder.

Per accident ea accident n a subr wvd addl insr. This form is to be completed by the insurance broker. This certificate of insurance does not constitute a contract between the issuing insurer s authorized representative or producer and the certificate holder. Fill in the complete name address and telephone number for the insurance agency.

Acord 25 2014 01 certificate of liability insurance acord 25 certificate of liability insurance is issued as a matter of information only and confers no rights upon the certificate holder. This certificate of insurance does not constitute a contract between the issuing insurer s authorized representative or producer and the certificate holder. Instructions for completing and submitting a certificate to the city of houston a the producer is the insurance agency. Certificate does not affirmatively or negatively amend extend or alter the coverage afforded by the policies below.

In an effort to better protect you our. Certificate of insurance standard form. Certificate does not affirmatively or negatively amend extend or alter the coverage afforded by the policies below. The acord name and logo are registered marks of acord if this certificate is being prepared for a party who has an insurable interest in the property do not use this form.