Certificate Of Property Insurance - Free Download
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Certificate Of Property Insurance
Certificate Of Property Insurance
CERTIFICATE HOLDER
DATE (MM/DD/YYYY)
CERTIFICATE OF PROPERTY INSURANCE
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE
POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
ACORD 24 (2009/09)
© 1995-2009 ACORD CORPORATION. All rights reserved.
SPECIAL CONDITIONS / OTHER COVERAGES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
TYPE OF INSURANCE POLICY NUMBER COVERED PROPERTY LIMITS
INSR
LTR
POLICY EFFECTIVE
DATE (MM/DD/YYYY)
POLICY EXPIRATION
DATE (MM/DD/YYYY)
PROPERTY
CAUSES OF LOSS
BASIC
BROAD
SPECIAL
EARTHQUAKE
FLOOD
BUILDING
PERSONAL PROPERTY
BUSINESS INCOME
EXTRA EXPENSE
BLANKET BUILDING
BLANKET PERS PROP
BLANKET BLDG & PP
$
$
$
$
$
$
$
$
$
WIND
DEDUCTIBLES
BUILDING
CONTENTS
RENTAL VALUE
$
INLAND MARINE
TYPE OF POLICY
CAUSES OF LOSS
NAMED PERILS
$
$
$
$
POLICY NUMBER
CRIME
TYPE OF POLICY
$
$
$
COVERAGES
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CERTIFICATE NUMBER: REVISION NUMBER:
LOCATION OF PREMISES / DESCRIPTION OF PROPERTY (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
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. Use ACORD 27 or ACORD 28.
INSURER A :
INSURED
PHONE
(A/C, No, Ext):
PRODUCER
PRODUCER
CUSTOMER ID #:
ADDRESS:
E-MAIL
FAX
(A/C, No):
INSURER B :
INSURER C :
CONTACT
NAME:
INSURER D :
INSURER E :
INSURER F :
NAIC #INSURER(S) AFFORDING COVERAGE
BOILER & MACHINERY /
EQUIPMENT BREAKDOWN
$
$
$
$
Clear All
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source: acegroup.com
Certificate Of Property Insurance
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