Request for a Certificate of Insurance
If you have a written request for a Certificate of Insurance you may write the name and policy number of the insured individual or company on the request and fax it to 248-305-5154 or email it to info@360rmi.com. Otherwise please complete the form below:
Name of the Insured:
Contact phone number:
Full Name and Address of the Certificate Holder:
Interest (landlord, bank, lienholder, etc):
Does the Certificate Holder need to be listed as a:
Loss Payee?
Mortgagee?
Additional Insured?
Is there any special wording that needs to appear on the certificate?