Request Insurance Certificate Massachusetts

Note: A certificate is only a snapshot of the coverage in place on the day it is issued. It does not grant coverage that is not provided by your policy.

The McSweeney & Ricci Processing Department responds to all Condo Certificate of Insurance requests as quickly as possible. To ensure a fast and accurate response, please fill out the form as completely as possible.

Date
MM slash DD slash YYYY
Insured/Condo Association Name*
Name of Person Requesting Certificate*
Certificate Holder Information
Borrower Name(s)
First Name Last Name
Borrower Unit Number and Complete address
Street Address Unit Number City State ZIP Code
Lender Name (Bank):
Loan Number:
Lender (Bank) Address:
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Special Conditions
Return Certificate to:
Special Instructions
Any certificate requesting Waiver of Subrogation, Primary & non-Contributory, CG2010, Pollution, 30 or more days notice of cancellation or specific wording must be accompanied by a copy of the request from your client. Please note that some of these coverage extensions require underwriter approval and may generate additional premium.
Instructions
Deliver By
Email
Phone
Fax
CAPTCHA
Name
This field is for validation purposes and should be left unchanged.

Condominium Certificate Request

Certificate Holder Information

Return Certificate to:

Special Instructions