CURM - Condominium Certificate Request

Condominium Certificate Request


	Please complete the following form to request a Certificate of Insurance for a Condominium Association currently insured with our agency (Unit Owners Only):

	Condominium Association Name:


	Unit Owner Information

	Your Name:


	Address:


	Unit No.:


	City:


	State:


	Zip Code:


	Phone No.:


	Email:


	Mortgage/Lender Information

	Company Name:


	Address:


	City:


	State:


	Zip Code:


	Loan No.:


	Delivery Information

	Attention:


	Company Name:


	Fax No.:


	Address:


	City:


	State:


	Zip Code:

Home of the Condominium Association Insurance Specialists

Commercial Underwriters Risk Management, Inc.

22720 Michigan Avenue, Suite 210
Dearborn, MI 48124

Toll Free: (800)856-8701
Local: (313)278-3800
Fax: (313)278-8467
Email