Template

COI request to broker

Every certificate. Nick Holton, Diversified Insurance Group.

Subject: COI Request — [GC Name] — [Project Name] — Needed by [Date]

Nick —

Please issue a certificate of insurance for:

Certificate holder: [legal name]
Holder address: [address]
Project: [name / number / address]
Limits / endorsements: [paste from GC request]
Description of operations: [text]

Maverick Performance Solutions LLC
25911 Northline Commerce Dr, Suite 306
Taylor, MI 48180

Original request attached.

Thank you,
[Name]

CC MichelleG@wediginsurance.com and Controller.
Reject any cert that still shows Farmington Hills or Golfcrest.