Fillable Certificate of Coverage - errors & omissions

Fill Online, Printable, Fillable, Blank Certificate of Coverage - errors & omissions Form

Use Fill to complete blank online SOUTH DAKOTA DLR pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

CERTIFICATE OF COVERAGE SOUTH DAKOTA REAL ESTATE COMMISSION REAL ESTATE AGENT’S ERRORS & OMISSIONS INSURANCE

On average this form takes 5 minutes to complete

The Certificate of Coverage - errors & omissions form is 1 page long and contains:

  • 1 signature
  • 5 check-boxes
  • 14 other fields

Country of origin: US
File type: PDF

Use our library of forms to quickly fill and sign your DLR forms online.

South Dakota Department of Labor & Regulation (DLRA) aim to promote economic opportunity and financial security in the South Dakota. They support individuals and businesses through expert services, employment solutions and business practices.

BROWSE SOUTH DAKOTA DLR FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
CERTIFICATE OF COVERAGE
SOUTH DAKOTA REAL ESTATE COMMISSION
REAL ESTATE AGENT’S ERRORS & OMISSIONS INSURANCE
For those South Dakota licensees insured by a private carrier pursuant to SDCL 36-21A-119 to
36-21A-123, and ARSD Chapter 20:69:15
I certify that the insurance company listed below is an admitted carrier in South Dakota. I
further certify that:
Licensee Name:______________________________________________________________
License Number:____________ Type: Broker_______ Sales_______ Auctioneer_______
Property Manager_______ Licensed Firm_______
Real Estate Company:_________________________________________________________
Address:___________________________________________________________________
is insured against claims resulting from professional acts for real estate brokerage as
contemplated in SDCL 36-21A-6 and 36-21A-12 and conditions of coverage as those required
by the South Dakota Real Estate Commission specifications contained in ARSD Chapter
20:69:15.
If coverage for the licensee insured in this policy is to be lapsed or nonrenewed, the providing
company must notify the South Dakota Real Estate Commission, 221 West Capitol Ste 101,
Pierre, SD 57501-2017 of its intent to lapse or nonrenew the coverage a minimum of 30 days
before the expiration date of the term. If the insurance is cancelled for non-payment of
premium, the company must notify the Commission at time of cancellation.
Insurance Company Name:_____________________________________________________
Company
Address:___________________________________________________________________
Policy Number:___________________ Effective Dates: from__________ to__________
Policy Limits: Each claim__________; Aggregate__________ Deductible__________
By:___________________________________________________ Date:________________
(Authorized Representative of insurance company)
Address:___________________________________________________________________
SDREC-E&O CERT (12/99)
dd mmm yyyy
dd mmm yyyy
click to sign
signature
click to edit
dd mmm yyyy
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

Certificate of Coverage - errors & omissions

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 4 December 2018

Message

View Audit Log
Print With Audit Log
Duplicate Document