SAMPLE REQUEST LETTER - Orchard Park Fire District
SAMPLE REQUEST LETTER
DATE
Name & Address of your
Contractor, vendor, or tenant
Re: Request for Certificates of Insurance
Dear :
In the next seven business days, please provide us with current certificates of insurance providing proof that coverage is in force. Your policy coverages, limits of insurance and insurance provisions must be identical to those that appear on the attached Sample Certificate of Insurance. We must have your current certificate on file before any work can be done or deliveries made to a job site.
Liability Certificate- ACORD 25
← ACORD 25 certificates of insurance are required from all contractors, sub-contractors, vendors, tenants, and any organization utilizing facilities.
← Your ACORD certificate of insurance must conform to the coverage and language on the attached sample certificate.
← Your ACORD 25 certificate must include the project name.
← Take special note of the (1) additional insured on a primary non-contributory basis (2) inclusion of ongoing & completed operations and , (3) waiver of subrogation
←
Workers Compensation Certificate- Separate certificate is required as Follows:
← Form C-105.2 Certificate of Workers Compensation Insurance
OR
← Form U—26.3 State Insurance Fund Certificate of Insurance
OR
← Form SI-12 Certificate of Workers Compensation Self Insurance
OR
← Form GSI-105.2- Certificate of Participation in Workers Compensation Group Self Insurance
← Take special note (1) Workers Compensation Certificate must advise of officer inclusion or exclusion.
You will not be permitted on a job site without the required certificates as requested. Authorization is granted to us to either withhold payments or terminate the subcontract until fully executed certificates of insurance are received by us.
Please contact me if you have any questions.
Sincerely,
................
................
In order to avoid copyright disputes, this page is only a partial summary.
To fulfill the demand for quickly locating and searching documents.
It is intelligent file search solution for home and business.
Related download
- sample request for a certificate of insurance
- part 1 browardschools
- sample cobra letter to employees on company letterhead
- acord certificate of liability insurance
- sample request letter orchard park fire district
- mechanical design criteria browardschools
- overpayment notification sample letter
- texas claim edi data dictionary
Related searches
- employment verification request letter sample
- sample request for hearing form
- personal loan request letter sample
- verification letter request letter example
- financial request letter sample
- persuasive request letter example
- sample request form
- product sample request form template
- product sample request form
- sample request form template
- persuasive request letter sample
- request letter template