Certificate Request Help

Business Name - Your business name.

Certificate Holder - The name of the entity that is requesting a certificate.

Effective Date - The start date of your insurance policy.

Additional Insured: Yes/No - Does the entity need to be listed as an additional insured on your policy?

Primary Wording: Yes/No - Does the entity require special/specific wording on the certificate?

Special Instructions - Is there anything special that needs to be noted on the certicate? (ei. job location, job number, attentions)