Certificate Forms

At Kelly Insurance Group, we are certified insurance brokers and agents  that specialize in providing insurance solutions to businesses and individuals. One of the services we offer is assistance with certificates of insurance (COI) and other insurance complex insurance forms.

Additional Forms for Certificates of Insurance

In addition to our COI services, we also offer a range of other insurance solutions to meet your needs. Our team can assist you with finding the appropriate insurance coverage for your business or personal needs, whether it’s general liability, property insurance, workers compensation, or other types of coverage.

General Liability Certificate Forms

CG 20 11 04 13 ADDITIONAL INSURED

MANAGERS OR LESSORS OF PREMISES by ENDORSEMENT

CG 20 13 04 13 ADDITIONAL INSURED

STATE, GOVERNMENT, POLITICAL AGENCY by ENDORSEMENT

CG 20 26 04 13 ADDITIONAL INSURED

DESIGNATED PERSON OR ORGANIZATION by ENDORSEMENT

CG 20 10 11 85 ADDITIONAL INSURED

OWNERS, LESSEES OR CONTRACTORS by ENDORSEMENT

CG 20 15 04 13 ADDITIONAL INSURED

VENDOR ADDITIONAL INSURED by BLANKET FORM

CG 20 01 04 13 PRIMARY WORDING

PRIMARY AND NON CONTRIBUTORY by BLANKET

CG 20 10 04 13 ONGOING OPERATIONS

OWNERS, LESSEES, & CONTRACTORS by ENDORSEMENT

CG 20 37 07 04 COMPLETED OPERATIONS

OWNERS, LESSEES, & CONTRACTORS by BLANKET

CG 20 37 10 01 COMPLETED OPERATIONS

OWNERS, LESSEES OR CONTRACTORS by ENDORSEMENT

CG 24 04 05 09 WAIVER of RIGHTS

TRANSFER OF RIGHTS OF RECOVERY by ENDORSEMENT

Commercial Automobile Certificate of Insurance Forms

CA 04 44 03 10 WAIVER of RIGHTS

BUSINESS AUTOMOBILE WAIVER of SUBROGATION by ENDORSEMENT

00 CA0070 00 09 06 ADDITIONAL INSURED

BUSINESS AUTOMOBILE ADDITIONAL INSURED CERTIFICATE FORM by ENDORSEMENT

Workers Compensation Certificate Forms

WC 00 03 13 WAIVER

WORKERS COMPENSATION WAIVER of RIGHTS to RECOVER by ENDORSEMENT