Get the free Certificate Holder/Additional Insured Request Form

Certificate Holder/Additional Insured Request Form. Insured Information (please print or type and fax to 214-360-0802. Organization Name. Insured Number ...

How to fill out certificate holderadditional insured request

How to fill out a certificate holder/additional insured request:

1. Begin by gathering all the necessary information: The name and address of the certificate holder, the policy number or reference number, the effective date of the request, and any specific requirements or endorsements needed.
2. Fill out the certificate holder section: Clearly write the name, address, and contact information of the certificate holder. Double-check for accuracy.
3. Fill out the additional insured section: If there are specific additional insured parties, carefully list their names, addresses, and contact information. Ensure that the names are spelled correctly and that the addresses are accurate.
4. Provide policy details: Include the policy number or reference number associated with the request. Double-check to make sure you have entered the correct information.
5. Specify effective dates: Indicate the start and end date of coverage as required. Ensure that the dates align with the project or agreement for which the certificate is being requested.
6. Include any special requirements or endorsements: If there are any specific additional endorsements or requirements needed, make sure to clearly state them. This could include certain liability limits, waivers of subrogation, or other specific terms.
7. Review and confirm all information: Before submitting the request, carefully review all the information provided. Double-check for any errors or missing details.

Who needs a certificate holder/additional insured request?

1. Contractors: When working on a construction or renovation project, contractors may need to provide a certificate holder/additional insured request to demonstrate that they have liability insurance coverage.
2. Vendors or suppliers: Some businesses require their vendors or suppliers to have additional insured status to protect themselves from any potential liability arising from the products or services provided.
3. Event organizers: When hosting an event, organizers may require vendors, performers, or other participants to provide proof of insurance with them listed as additional insured parties.
4. Landlords or property owners: Landlords or property owners may request a certificate holder/additional insured status from tenants to protect themselves from any liability that may arise from the tenant's activities on the property.
5. Other businesses or service providers: Various industries and business relationships may require a certificate holder/additional insured request to safeguard against any potential liability issues that may arise during the course of their work.

In conclusion, filling out a certificate holder/additional insured request requires gathering the necessary information, providing accurate details about the certificate holder and additional insured parties, including policy details, specifying effective dates, and considering any special requirements or endorsements. This request is typically needed by contractors, vendors, event organizers, landlords, and various other businesses or service providers to protect against liability concerns.

For pdfFiller’s FAQs

What is certificate holderadditional insured request?

A certificate holder additional insured request is a formal request made by a third party to be included as an additional insured on an insurance policy.

Who is required to file certificate holderadditional insured request?

The certificate holder, typically a client or business partner, is required to file the request.

How to fill out certificate holderadditional insured request?

The request must be filled out with the necessary information about the third party seeking additional insured status, and submitted to the insurance provider.

What is the purpose of certificate holderadditional insured request?

The purpose is to provide liability protection for the third party in case of any claims or lawsuits related to the policy.

What information must be reported on certificate holderadditional insured request?

The request must include the name and contact information of the third party, the specific coverage requested, and any other relevant details.

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