CERTlFlCATE OF INSURANCE REQUEST FORME-MAIL - firstname.lastname@example.orgFax: (916) 939-1085 Phone: (916) 939-1080
PLEASE FILL OUT THE FOLLOWING INFORMATION:
SPECIAL INSTRUCTIONS: Please check all that apply.
***** Please include client's written instructions if any *****
The additional insured endorsement will not respond with out a Written Contract That stipulates the additional insured endorsement.
* If you choose the e-mail option, make sure you have entered the correct e-mail addresses for those you need the certificate sent to. Please make note, in this case the e-mailed copy will be considered the original certificate.