Unique Risk Management & Insurance Services, LLC

Certificate of Insurance Request

Named Insured
Account Name:
Address 1:
Address 2:
City:
State:
Zip Code:
Requested by:
enter your name
Requestors Email Address:
Requestors Phone Number:
Requestors Fax Number:
Certificate Holder
Name:
Address 1:
Address 2:
City:
State:
Zip Code:
Delivery Information
Delivery Method (Please select one) Fax  Email
Email Address:
Fax Number:
Attention to:
Required Coverage Information
(*) please provide description below
  Limit Required: Add'l Insured: Add'l Information
General Liability: (*)
Automobile Liability: (*)
Automobile Physical Damage: (*)
Propert/Contents: (*)
Equipment: (*)
Umbrella: (*)
Workers Compensation:
Other:
Required Coverage information description
Please enter description from selections above.
Description:
Additional Insured:
please select one		 GL  Auto
Describe Interest of Certificate Holder
Select Interest Type Loss Payee  Mortgagee
Special Instructions:
Please Select: Primary  Non-Contributory
Waiver of Subrogation: GL  Auto  Workers' Comp
Cancellation: Yes  No
If Cancellation (please specify):
Other (please specify):
Certificate Information
Description of Operations:
Insuror Letter:
Cancellation Days:
Additional Information
Your Email Address:
Additional Notes:
* = Required Field
Attention: Please FAX or EMAIL a copy of the contract and insurance requirments to our office. - Select LOCATIONS under WHO WE ARE on our menu for the appropriate contact information.
Send

CA License #0F56527

Welcome to Unique Risk Management and Insurance Services LLC.  

We are a full service independent insurance agency offering commercial and personal lines as well as employee benefits.

We are committed to providing you with the best possible coverage, tailored to your specific needs at a reasonable cost.

29833 Santa Margarita Parkway
Suite 400
Rancho Santa Margarita , CA 92688

Tel: 949-305-5577 
Fax: 949-305-5077
Toll Free: (877) 2B - Unique 

 

Insurance News

Love Your Valentine's Day Gift? Insure It!
Fri, 14 Oct 2011 21:38:05 GMT
Valentine’s Day is upon us, and thoughts of people everywhere turn to… jewelry. Those who don’t buy shiny things for Valentine’s Day may prefer other types of valuables, such as electronics, artwork, antiques, wine and furs. All totaled Valent...
Read More
Home Inventory: Know Your Stuff
Wed, 25 Jan 2012 13:05:48 GMT
Most people know that a homeowners or renter’s insurance policy is crucial when it comes to protecting your home from a fire or other disaster. However, if you want to safeguard your valuables from the unexpected, there’s another important documen...
Read More
Hosting a Super Bowl Party? There Could Be More than Team Pride on the Line
Fri, 03 Feb 2012 18:37:29 GMT
Hosting a Super Bowl party is a great way to cheer on your team if you can’t make it to the stadium in Indianapolis this Sunday, but make sure you know and manage the risks of hosting the big game day party. In many states, individuals hosting parti...
Read More
One Roof
Fri, 14 Oct 2011 21:38:05 GMT
Eliminating the chaos that comes along with managing so many different policies is a major advantage of using a Trusted Choice® insurance agent. Placing your business insurance through a Trusted Choice® agent brings someone onto your team who can br...
Read More
Does Volunteering Your Time Mean Volunteering Your Insurance?
Fri, 14 Oct 2011 21:38:04 GMT
Millions of Americans donate time—their most valuable asset—to serve as a volunteer board member on non-profits, booster clubs, churches, PTAs and civic organizations, just to name a few. The decisions these folks make can have a dramatic impact o...
Read More