Certificate of Insurance Request
*** Please read before beginning the request. ***
DO NOT COMPLETE THIS FORM if you are a BORROWER or HOMEOWNER. This is a form for LENDERS ONLY.
If you are refinancing or getting an Equity Line, and your lender has instructed you to contact us for any Policy Information, contact your lender and have them fill out this form to expedite the process.
IF YOU RECEIVED A LETTER FROM YOUR LENDER, please call (727) 442-0012 extension 206.
Our agency does not accept “Rush” or “Urgent” requests.
You MUST have the mortgagee clause and loan number to complete the request.
Please complete the request form in its entirety before submitting it. Skipping fields and incorrect information will result in a voided request. If you are unsure of what proof of coverage is needed, please check ALL coverage boxes.
It is not the responsibility of The Turner Insurance Advisor Group, Inc to obtain correct and accurate information on your behalf.
certificate requests will be completed within 48 business hours.
All other certificate requests/proof of insurance requests - can take up to 7 business days to be completed. There will be no exceptions.
We will not accept Rush or Urgent Requests. There will be no exceptions!
Certificate Requests will be done in the order they are received*
NOTE: You must tab or click in each field. DO NOT HIT ENTER or BACK or the form will be deleted and you will need to re-enter your information. Click SUBMIT once the form is completed.
Your Email Address:
You must provide a VALID-Working email address. Failure to do so will result in a voided request. A copy of your request will be emailed to the email address entered.
Condominium or Subdivision Name:
Borrower(s) First and Last Name:
Include unit/apt # if applicable.
Valid Email to Send Request:
We WILL NOT fax information. Email MUST be provided.
Mortgagee Clause (Complete with Address, City, State & Zip Code):
**Be Advised: Requesting “Master Policy” is insufficient to fulfill the Certificate Request. YOU MUST SELECT FROM COVERAGES LISTED BELOW.
Crime / Fidelity / Employee Dishonesty
Directors and Officers
Equipment Breakdown / Boiler & Machinery
Flood & Declarations Page
Ordinance or Law
**When applicable a standard ACORD Form, RCBAP and policies will be sent with request.
DO NOT REQUEST THE TOTAL NUMBER OF UNITS FOR ENTIRE PROPERTY TO BE LISTED ON THE CERTIFICATE. WE WILL NOT PROVIDE THAT. THAT INFORMATION WILL BE FOUND IN THE POLICIES. NO EXCEPTIONS WILL BE MADE.
Comments or Other Instructions
This field is for validation purposes and should be left unchanged.
This iframe contains the logic required to handle Ajax powered Gravity Forms.
February 19th, 2012
The Turner Insurance Advisor Group