Blank Texas Certificate Insurance PDF Form Get Texas Certificate Insurance Here

Blank Texas Certificate Insurance PDF Form

The Texas Certificate of Insurance (COI) is a crucial document required for Master Plumbers acting as Responsible Master Plumbers (RMPs). This certificate verifies that the RMP maintains the necessary insurance coverage while performing plumbing services. It ensures compliance with state regulations and protects both the plumber and the public from potential liabilities.

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The Texas Certificate of Insurance (COI) is an essential document for Master Plumbers who wish to operate as Responsible Master Plumbers (RMP). Before taking on this role, a Master Plumber must submit a current COI to the Texas State Board of Plumbing Examiners. This certificate serves multiple purposes, including confirming that the plumber holds the necessary insurance coverage to perform their duties safely and legally. The COI must be kept up to date, as it expires when the associated insurance policy does. It is crucial for RMPs to maintain minimum insurance coverage at all times, which includes liability for property damage or bodily injury. The form requires specific details, such as the RMP's name, license number, and business information, along with the insurance company’s details. Notably, the COI does not change the terms of the underlying insurance policy; instead, it reflects the coverage in place. Additionally, any changes to the insurance policy, such as cancellation or non-renewal, must be communicated to the Board. Understanding the requirements and implications of this form is vital for compliance and protection in the plumbing profession.

Texas Certificate Insurance Preview

TEXAS STATE BOARD OF PLUMBING EXAMINERS

PO BOX 4200 • AUSTIN, TX 78765-4200 • (512) 936-5200 Scan and Email to: insurance@tsbpe.texas.gov

Allow up to 10 days for processing before contacting this office for confirmation of receipt of certificate.

CERTIFICATE OF INSURANCE (COI)

A Master Plumber shall furnish the Texas State Board of Plumbing Examiners (Board) with a current Certificate of Insurance (COI) before acting as a Responsible Master Plumber (RMP). This COI expires on the date that the insurance policy specified herein expires. The RMP shall furnish the Board with a current COI immediately upon or prior to the expiration of this COI. At least the minimum insurance coverage specified in (1) and (2) below shall be maintained at all times during which the Master Plumber acts as a RMP. The insurance coverage must include all types of plumbing that will be performed under the RMP’s license, including if applicable, liquefied petroleum gas plumbing, medical gas plumbing, and multipurpose residential fire protection sprinkler plumbing. The Certificate Holder does not guarantee the accuracy of any information provided in this COI. This COI neither affirmatively or negatively amends, extends, or alters the coverage afforded by the insurance policy specified herein. The terms of the policy control over the terms of this certificate.

Responsible Master Plumber (RMP) Name:License #: M‒____________

Business Name: _______________________________________________ Telephone: (_______)_____________________

RMP Email Address: ___________________________________________________________________________________

RMP Address: _________________________________________________________________________________________

StreetCityState Zip

Business Owner Name: _________________________________________________________________________________

Insurance Company: ___________________________________________________________________________________

Policy Number:Effective Date: ______________ Expire Date: ______________

Name of Insurance Agency: ___________________________________________ Agent Phone: (______)_______________

Insurance Agent Email Address:

Insurance Agency Address:

Street

City

State

Zip

By my signature below, as an agent for an insurer authorized to engage in the business of insurance in this state or an eligible surplus lines insurer, as defined by Section 981.002, Insurance Code, I hereby sign this Certificate of Insurance (COI) stating that the above policy meets at least the following minimum standards:

(1)provides for commercial general liability insurance for the above named Responsible Master Plumber for claims for property damage or bodily injury, regardless of whether the claim arises from a negligence claim or on a contract claim; and

(2)is in a coverage amount of not less than $300,000 for all claims arising in any one-year period.

__________________________________

____________________________________

___________________________

Signature of Agent

Printed Name of Agent

Date

CERTIFICATE HOLDER ADDRESS:

TEXAS STATE BOARD OF PLUMBING EXAMINERS PO BOX 4200

AUSTIN, TX 78765-4200

PHONE: (512) 936-5200 EXT. 65203 www.tsbpe.texas.gov

Revised August 2017

CANCELLATION:

Should any of the above described policies be cancelled, non-renewed, or otherwise modified, the Texas State Board of Plumbing Examiners (Certificate Holder) will be notified in accordance with the terms of the underlying policy.

Approved by TDI 09/26/2017, Filing Link No. S644091

Document Specs

Fact Name Fact Description
Governing Authority The Texas Certificate of Insurance form is governed by the Texas State Board of Plumbing Examiners.
Required for RMP A Master Plumber must provide a current Certificate of Insurance before acting as a Responsible Master Plumber (RMP).
Expiration of COI The Certificate of Insurance expires on the date the specified insurance policy expires.
Minimum Coverage Insurance coverage must include at least $300,000 for all claims in any one-year period for property damage or bodily injury.
Notification of Changes The Texas State Board of Plumbing Examiners will be notified of any cancellations or modifications to the insurance policy.
Processing Time Allow up to 10 days for processing after submitting the Certificate of Insurance.
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