Get the free CERTIFICATE & ADDITIONAL INSURED REQUEST FORM

This form is used to request a certificate and additional insured from H. R. Keller & Co., Inc. It details the requirements and information needed for certificate issuance.

How to fill out certificate additional insured request

How to fill out CERTIFICATE & ADDITIONAL INSURED REQUEST FORM

1. Start by downloading the CERTIFICATE & ADDITIONAL INSURED REQUEST FORM from the official website.
2. Fill in the date at the top of the form.
3. Provide the name of the insured party in the designated field.
4. Enter the address of the insured individual or organization.
5. Specify the type of insurance coverage required in the appropriate section.
6. Include the name and contact information of the requester.
7. Clearly outline the additional insured parties, if applicable.
8. Review the form for accuracy and completeness.
9. Sign and date the form at the bottom.
10. Submit the completed form to the insurance company or agent for processing.

Who needs CERTIFICATE & ADDITIONAL INSURED REQUEST FORM?

1. Individuals or organizations requiring proof of insurance for contracts or agreements.
2. Contractors who need to add clients as additional insured parties.
3. Real estate professionals during property transactions.
4. Event organizers seeking coverage for venues.
5. Businesses seeking compliance with industry regulations.

For pdfFiller’s FAQs

What is CERTIFICATE & ADDITIONAL INSURED REQUEST FORM?

The Certificate & Additional Insured Request Form is a document used to request a certificate of insurance, listing additional insured parties as specified in a contract or agreement.

Who is required to file CERTIFICATE & ADDITIONAL INSURED REQUEST FORM?

Typically, contractors, vendors, or subcontractors who need to provide proof of insurance coverage to a client or organization that requires them to be added as additional insured are required to file this form.

How to fill out CERTIFICATE & ADDITIONAL INSURED REQUEST FORM?

To fill out the form, one needs to provide the policyholder's name, the insurance company's details, the specific parties to be added as additional insured, and any relevant contract references or policy numbers.

What is the purpose of CERTIFICATE & ADDITIONAL INSURED REQUEST FORM?

The purpose of the form is to formally request a certificate of insurance that serves to verify coverage and fulfill contractual obligations by showing that other parties are protected under the insurance policy.

What information must be reported on CERTIFICATE & ADDITIONAL INSURED REQUEST FORM?

The information that must be reported includes the name of the insured, policy number, effective dates, types of coverage, and names of the additional insured parties as well as any specific terms or conditions.