HDR Insurance - Certificate Request

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Certificate of Insurance Requests

Certificate of Insurance Request Forms
	The forms below can be saved to your computer. You can then fill them out and send them via email or fax to your agent as noted above under "Agency Affiliation". The only time you need to send them to your agent is if a signature is required for a specific type of endorsement (i.e., CG 20 10 11 85) or you are not able to email it.
	The Adobe Acrobat reader is required for use of these forms and can be obtained at no cost at Adobe's web site: http://www.adobe.com/products/acrobat/readstep2.html. The reader is available for most computers making this form usable on Windows, Macintosh and other popular systems. If you have any problems with this form or its use, please send us an email stating the problems you are experiencing and we will suggest appropriate solutions.

		For QBE/Praetorian Policyholders (formerly Clarendon America): Certificate Request Form (edition 5-08) (this is a fill-in form) The insureds signature is required if requesting a CG 20 10 11 85, CG 20 37 07 04, CG 24 04 10 93 or CG 20 26 11 85 Additional Insured Endorsement. There are premium charges applicable to these endorsements. Certificate of Warranties (edition 4-07) This no loss letter is needed when requesting CG 20 10 11 85, CG 20 26 11 85 or CG 20 37 07 04 Additional Insured Endorsement for a completed project.
		For Majestic Insurance Company Policyholders: Workers' Compensation Waiver of Subrogation Request Form (edition 04-05)



Questions or Concerns about Service:
	If you have any concerns or issues regarding service, please call us or send an email to customerservice@hdrins.com. It is our goal to provide you with timely, accurate, and quality service.

Last Updated: 06-Jun-2008 by LREckert
Last Review: 06-Jun-2008 by LREckert