Contents
Form Example
TEXAS STATE BOARD OF PLUMBING EXAMINERS
PO BOX 4200 • AUSTIN, TX
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
__________________________________ |
____________________________________ |
___________________________ |
Signature of Agent |
Printed Name of Agent |
Date |
CERTIFICATE HOLDER ADDRESS:
TEXAS STATE BOARD OF PLUMBING EXAMINERS PO BOX 4200
AUSTIN, TX
PHONE: (512)
Revised August 2017
CANCELLATION:
Should any of the above described policies be cancelled,
Approved by TDI 09/26/2017, Filing Link No. S644091
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Common mistakes
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Incomplete Information: Failing to fill out all required fields can lead to delays. Ensure that every section, such as the Responsible Master Plumber's name, license number, and business details, is fully completed.
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Incorrect Policy Dates: Providing incorrect effective or expiration dates for the insurance policy is a common mistake. Double-check these dates to ensure they align with the insurance coverage period.
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Missing Signature: Omitting the signature of the insurance agent can result in the form being rejected. Always make sure that the agent’s signature is present before submitting the form.
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Not Following Submission Guidelines: Ignoring the specific submission instructions can cause processing issues. Remember to scan and email the form to the designated address and allow sufficient time for processing.
Key takeaways
When filling out and using the Texas Certificate of Insurance (COI) form, it is essential to keep the following key takeaways in mind:
- Submission Process: Ensure that the completed form is scanned and emailed to insurance@tsbpe.texas.gov. Allow up to 10 days for processing before reaching out for confirmation.
- Current Coverage Required: A Master Plumber must provide a current COI before acting as a Responsible Master Plumber (RMP). This certificate must be updated immediately upon or prior to expiration.
- Minimum Insurance Standards: The insurance must include coverage for all plumbing types performed under the RMP’s license, including liquefied petroleum gas plumbing and medical gas plumbing.
- Accuracy Disclaimer: The Certificate Holder does not guarantee the accuracy of the information in the COI. The terms of the underlying insurance policy take precedence over the certificate.
- Required Coverage Amount: The insurance policy must provide at least $300,000 in coverage for all claims arising in any one-year period, covering both property damage and bodily injury claims.
- Cancellation Notification: If any insurance policy is canceled or modified, the Texas State Board of Plumbing Examiners will be notified as per the terms of the policy.
Steps to Using Texas Certificate Insurance
Filling out the Texas Certificate of Insurance form is an essential step for Master Plumbers who wish to act as Responsible Master Plumbers. This form requires specific information about both the plumber and the insurance policy. It is important to ensure that all details are accurate and complete to avoid any delays in processing.
- Obtain the Texas Certificate of Insurance form from the Texas State Board of Plumbing Examiners website or directly from their office.
- Fill in the name of the Responsible Master Plumber (RMP) in the designated field.
- Enter the RMP's license number in the appropriate section.
- Provide the business name associated with the RMP.
- Input the RMP's telephone number, ensuring the area code is included.
- Include the RMP's email address for any correspondence.
- Complete the RMP's address, including street, city, state, and zip code.
- List the name of the business owner in the specified area.
- Enter the name of the insurance company providing coverage.
- Fill in the insurance policy number.
- Indicate the effective date of the insurance policy.
- Specify the expiration date of the insurance policy.
- Provide the name of the insurance agency that issued the policy.
- Input the phone number of the insurance agent.
- Include the insurance agent's email address.
- Complete the insurance agency's address, including street, city, state, and zip code.
- Have the insurance agent sign the form, providing their printed name and the date of signing.
- Ensure that the Certificate Holder address is correctly listed as the Texas State Board of Plumbing Examiners.
After completing the form, scan it and email it to the provided address. Make sure to allow up to ten days for processing before following up with the Board to confirm receipt. This will help ensure that your application is handled in a timely manner.