Proof of Insurance

Proof of Require Insurance
Residents of Management Services Corporation are required to maintain and provide the following Minimum Required Insurance coverage. This form must be completed and signed by the resident's authorized insurance agent and a copy of declarations page attached.

$50,000 Limit of Liability for Resident’s legal liability for damage to the Landlord’s property for no less than the following causes of loss: fire, smoke, explosion, backup or overflow of sewer, drain or sump, water damage, falling objects and collision with vehicles (“Minimum Required Insurance”).
Name of Insurance Company*
Name of Insurance Agent*
First Last
Insured Person*
First Last
Insured Address*
Street Address City State ZIP Code
Beginning Date of Coverage*
MM slash DD slash YYYY
Ending Date of Coverage*
MM slash DD slash YYYY
Amount of Coverage*
Please enter a number greater than or equal to 50000.
Policy Number*
Please upload your Declaration Page*
Max. file size: 40 MB.
Signature*
In Lieu of an original signature to this agreement, landlord will accept a valid and legitimate electronic signature and/or facsimile signature from the insurance agent. By signing below you certify that the above person has the minimum required insurance.

First Last

Proof of Require Insurance