CONDOMINIUM CERTIFICATE OF INSURANCE REQUEST Date MM slash DD slash YYYY please format as: mm/dd/yyyyBy (Requested)* From (Business Name)* Email* Phone*Prepare a Certificate of Condominium Insurance to the followingLender Name Lender Address Condominium Association Name Borrower Name First Last Second Borrower Name First Last Borrower Unit Number and Complete address Street Address Unit Number City State / Province / Region ZIP / Postal Code Loan Number Special Conditions Return to: Please enter email, fax number or mailing address of recipientPlease send me a copy of the Certificate: No Yes Certificate will be mailed, faxed or emailed per your request.A copy will be kept on file for the insured unless instructed otherwise. Certificate will be available within 24 hours.
