This tab contains all of the insured's requested certificates.
Enter the name of the organization the Certificate of Insurance Liability is being remitted to.
Enter the title of the contact person at the firm.
Enter the first name of the contact person at the firm.
Enter the last name of the contact person at the firm.
Enter the firm's mailing address, city, two digit state abbreviation, and Zip code in the appropriate fields.
Enter the firm's area code and work telephone number.
Enter the firm's area code and fax number.
Enter the firm's email address, be sure to include the @ symbol.
Enter any special notes on processing the certificate request.
Enter the date the certificate is sent or issued.
Enter the date the policy expires for the Certificate of Liability to remain valid.
A check mark is placed in this box if the active locations are to be printed on the Certificate.
A check mark is placed in this box if the included officers are to be printed on the Certificate.
A check mark is placed in this box if the "Waiver of Subrogation" clause is to be printed on the Certificate.