Certificates of Insurance

The enclosed link includes certificate samples for the most common situations related to the Moving & Storage Industry. A copy of the related endorsement, instructions, additional premium, and when additional information needs to be provided to your underwriter are also noted on the samples. For quick reference a glossary of approved wording and endorsements is also located in the enclosed.

  • Auto Liability Blanket Waiver of Subrogation Form 62897 has been changed to CA0444 – see AIG Certificate Glossary 9-6-2016 for applicable charges:
    • Verify that blanket waiver of subrogation is included in policy/endorsement and use form version endorsed on current policy.
    • If not endorsed on policy, then submit change request to processing@paulhanson.com to add and use designated form version when issuing certificate:
      • All states except CA, FL, HI, MA, NY & VA use form version CA 04 44 10 13
      • For CA, FL, HI, MA, NY & VA states use form version CA 04 44 03 10
  • General Liability Additional Insured Endorsement Form Changes for new and renewal policies issued effective April 1, 2016
    • General Liability Additional Insured with policy Eff before 4/1/2016 – check policy for appropriate edition to use (CG2026 07 04 or CG2026 04 13); (CG2010 07 04 or CG2010 04 13)
    • General Liability Additional Insured with policy Eff 4/1/2016 and after – use new form editions (CG2026 04 13 and CG2010 04 13)
    • Refer to the Certificate Sample Instructions for proper wording and policy endorsing requirements

Certificates of insurance issued from the insurance brokers office are to adhere to the wording and instructions as provided on the enclosed link. ALL issued certificates must be submitted to our office for record purpose only. Please note it is not our responsibility to check your acord certificate to endorse policy changes. A certificate does not amend the policy nor imply change of conditions. When a certificate requires a change in policy provisions submit an acord change request form.

Issued certificates submitted for review should be emailed to certificates@paulhanson.com.

We hope you find this information informative and useful to clarify your responsibility regarding certificates of insurance. If you have any questions, please contact Nichole Williams at nicholew@paulhanson.com.


Sample Wording and Instructions for AIG Insurance Policies