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Approved Certificates of Insurance beginning with A

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Some certificates of insurance may contain a copyright notice and are therefore protected from reproduction by federal copyright law. 17 U.S.C. §§1-1101. TDI must comply with copyright law and is not required to furnish copies of copyrighted records. Texas Government Code Annotated §552.027; Open Records Opinion 550 (1990); Texas Attorney General Opinion MW-307 (1981). Please contact the filing company, person, or organization to obtain a copy of the form.

Approved Certificates of Insurance beginning with A
Form Number Filing Number Company / Person / Organization Name Approval Date Form Name
7482 (8/12) 122759 Affiliated FM Insurance Company 09/11/2012 Policy Information Form View
7483 (8/12) 122759 Affiliated FM Insurance Company 09/11/2012 Certificate of Insurance View
8487 (12/11) 118033 Auto Club Indemnity Company 12/29/2011 Evidence of Liability Insurance - Special Event Texas Homeowners Policy - Form D (AAA Texas) View
8488 (12/11) 118033 Auto Club Indemnity Company 12/29/2011 Evidence of Liability Insurance - Special Event Texas Homeowners Policy - Form B (AAA Texas) View
8680 07/13 129703 Auto Club Indemnity Company 09/24/2013 Evidence of Liability Insurance Texas Tenant Policy - Form B View
A 3006 07 16 S640548 Allied Property and Casualty Insurance Company 06/13/2017 Certificate of Liability Insurance View
AA C 002 12 12 121390 Amica Mutual Insurance Company 06/20/2012 Certificate of Insurance View
AA C 002 12 12 S630866 Amica Property and Casualty Insurance Company 10/18/2016 Certificate of Insurance View
AC Lein 10 05 121261 Air-Sur, Inc. 07/03/2012 Certificate of Insurance View
ACORD 101 (2008/01) 118618 ACORD Corporation 01/06/2012 Additional Remarks Schedule View
ACORD 20 (2009/12) 116059 ACORD Corporation 08/23/2011 Certificate of Aviation Liability Insurance (Revised by TDI Link No. S21379) View
ACORD 20 (2016/03) S21379 Acord Corporation 05/14/2015 Certificate of Aviation Liability Insurance View
ACORD 21 (2009/12) 116060 ACORD Corporation 08/23/2011 Certificate of Aircraft Insurance (Revised by TDI Link No. S21379) View
ACORD 21 (2016/03) S21379 Acord Corporation 05/14/2015 Certificate of Aircraft Insurance View
ACORD 22 (2010/03) 116061 ACORD Corporation 08/23/2011 Intermodel Interchange Certificate of Insurance (Revised by TDI Link No. 119689) View
ACORD 22 (2012/04) 119689 ACORD Corporation 03/05/2012 Intermodal Interchange Certificate of Insurance (Revised by TDI Link No. S23134) View
ACORD 22 (2016/03) S23134 ACORD Corporation 06/12/2015 Intermodal Interchange Certificate of Insurance View
ACORD 23 (2010/05) 117879 ACORD Corporation 11/18/2011 Vehicle or Equipment Certificate of Insurance (Revised by TDI Link No. S23134) View
ACORD 23 (2016/03) S23134 ACORD Corporation 06/12/2015 Vehicle or Equipment Certificate of Insurance View
ACORD 24 (2009/09) 117880 ACORD Corporation 11/18/2011 Certificate of Property Insurance (Revised by TDI Link No. S20848) View
ACORD 24 (2016/03) S20848 Acord Corporation 05/05/2015 Certificate of Property Insurance View
ACORD 25 (2010/05) 117881 ACORD Corporation 11/18/2011 Certificate of Liability Insurance (Revised by TDI Link No. 125767) View
ACORD 25 (2013/04) 125767 ACORD Corporation 02/12/2013 Certificate of Liability Insurance (Revised by TDI Link No. 127807) View
ACORD 25 (2014/01) 127807 ACORD Corporation 05/21/2013 Certificate of Liability Insurance (Revised by TDI Link No. S21357) View
ACORD 25 (2016/03) S21357 Acord Corporation 05/14/2015 Certificate of Liability Insurance View
ACORD 27 (2009/12) 116124 ACORD Corporation 08/24/2011 Evidence of Property Insurance View
ACORD 28 (2009/12) 116125 ACORD Corporation 08/24/2011 Evidence of Commercial Property Insurance (Revised by TDI Link No. 122775) View
ACORD 28 (2011/11) 122775 ACORD Corporation 08/29/2012 Evidence of Commercial Property Insurance (Revised by TDI Link No. 125768) View
ACORD 28 (2013/04) 125768 ACORD Corporation 02/12/2013 Evidence of Commercial Property Insurance (Revised by TDI Link No. 127809) View
ACORD 28 (2014/01) 127809 ACORD Corporation 05/21/2013 Evidence of Commercial Property Insurance (Revised by TDI Link No. S610779) View
ACORD 28 (2016/03) S610779 ACORD Corporation 07/13/2015 Evidence of Commercial Property Insurance View
ACORD 29 (2010/12) 116126 ACORD Corporation 08/24/2011 Evidence of Flood Insurance (Revised by TDI Link No. 129181) View
ACORD 29 (2013/10) 129181 ACORD Corporation 08/08/2013 Evidence of Flood Insurance (Revised by TDI Link No. S611459) View
ACORD 29 (2016/03) S611459 ACORD Corporation 07/27/2015 Evidence of Flood Insurance View
ACORD 30 (2010/12) 116127 ACORD Corporation 08/24/2011 Certificate of Garage Insurance (Revised by TDI Link No. 125769) View
ACORD 30 (2013/04) 125769 ACORD Corporation 02/12/2013 Certificate of Garage Insurance (Revised by TDI Link No. 127810) View
ACORD 30 (2014/01) 127810 ACORD Corporation 05/21/2013 Certificate of Garage Insurance (Revised by TDI Link No. S21648) View
ACORD 30 (2016/03) S21648 Acord Corporation 05/18/2015 Certificate of Garage Insurance View
ACORD 31 (2012/08) 121486 ACORD Corporation 06/15/2012 Certificate of Marine / Energy Insurance (Revised by TDI Link No. 125770) View
ACORD 31 (2013/04) 125770 ACORD Corporation 02/12/2013 Certificate of Marine / Energy Insurance (Revised by TDI Link No. 127808) View
ACORD 31 (2014/01) 127808 ACORD Corporation 05/21/2013 Certificate of Marine / Energy Insurance (Revised by TDI Link No. S21357) View
ACORD 31 (2016/03) S21357 Acord Corporation 05/14/2015 Certificate of Marine /Energy Insurance View
ACORD 854 TX (2012/08) 122750 ACORD Corporation 08/28/2012 Texas Risk Pool Certificate of Property Coverage View
ACORD 855 TX (2012/08) 122751 ACORD Corporation 08/28/2012 Texas Risk Pool Certificate of Liability Coverage (Revised by TDI Link No. S16145) View
ACORD 855 TX (2015/02) S16145 ACORD Corporation 03/03/2015 Texas Risk Pool Certificate of Liability Coverage View
AG30-ATT (4/10) 119075 American Home Assurance Company 04/02/2012 Chartis Aerospace Insurance Services, Inc. Attachment to Certificate No. View
AG30-SCH/LIMITS (4/10) 119075 American Home Assurance Company 04/02/2012 Chartis Aerospace Insurance Services, Inc. Attachment to Certificate No. View
AG30-SCH (4/10) 119075 American Home Assurance Company 04/02/2012 Chartis Aerospace Insurance Services, Inc. Attachment to Certificate No. View
AG30-TX (02/12) 119075 American Home Assurance Company 04/02/2012 Certificate of Insurance – Texas (Chartis) View
AH 00 30 01 12 S645226 Amica Mutual Insurance Company 09/19/2017 Certificate of Insurance View
Airp 10 05 121261 Air-Sur, Inc. 07/03/2012 Certificate of Insurance View
AL31B-TX (02/12) 119075 American Home Assurance Company 04/02/2012 Certificate of Insurance – Texas (Chartis) View
AL31-TX (02/12) 119075 American Home Assurance Company 04/02/2012 Certificate of Insurance – Texas (Chartis) View
ALL-38010 (04/13) 126635 ACE American Insurance Company 04/17/2013 Certificate of Insurance View
ALL-38010 (04/13) 126635 ACE Property and Casualty Insurance Company 04/17/2013 Certificate of Insurance View
ALLIANTFORM.2012 118617 Alliant Insurance Services, Inc. 03/06/2012 Certificate of Insurance View
American Safety Storage Tank Certificate and Schedule (3/12) 118810 American Safety Indemnity Company 03/19/2012 Certificate of Insurance View
American Safety Storage Tank Certificate and Schedule (3/12) 120079 American Safety Casualty Insurance Company 05/07/2012 Certificate of Insurance View
American Safety Storage Tank Certificate and Schedule (3/12) 120090 American Safety Risk Retention Group, Inc. 04/19/2012 Certificate of Insurance View
AV30A (11/07) 119075 American Home Assurance Company 04/02/2012 Attachment to Certificate of Insurance issued to: View
AV31B-TX (02/12) 119075 American Home Assurance Company 04/02/2012 Certificate of Insurance – Texas (Chartis) View
AV31-TX (02/12) 119075 American Home Assurance Company 04/02/2012 Certificate of Insurance - Texas (Chartis) View
AXIS 8000(08/10) 119572 AXIS Insurance Company 04/19/2012 Certificate of Insurance View
AXIS 8001(08/10) 119572 AXIS Insurance Company 04/19/2012 Certificate of Insurance View
CAL 02 12 119745 Aon Risk Services Southwest, Inc. 04/19/2012 Certificate of Insurance No. View
CAL 06 12 121343 Aon Risk Services Southwest, Inc. 06/26/2012 Certificate of Insurance No. View
CAV30ATT-TX (02/12) 119075 American Home Assurance Company 04/02/2012 Certificate of Insurance Attachment – Texas (Chartis) View
CAV30B-TX (02/12) 119075 American Home Assurance Company 04/02/2012 Certificate of Insurance – Texas (Chartis) View
CAV30HK-TX (02/12) 119075 American Home Assurance Company 04/02/2012 Certificate of Insurance – Texas (Chartis) View
CAV30-SCH/LIMITS (4/10) 119075 American Home Assurance Company 04/02/2012 Chartis Aerospace Insurance Services, Inc. Attachment to Certificate of No. View
CAV30-SCH/V3 (5/10) 119075 American Home Assurance Company 04/02/2012 Chartis Aerospace Insurance Services, Inc. Attachment to Certificate of No. View
CAV30-SCH (4/10) 119075 American Home Assurance Company 04/02/2012 Chartis Aerospace Insurance Services, Inc. Attachment to Certificate of No. View
CAV30-TX (02/12) 119075 American Home Assurance Company 04/02/2012 Certificate of Insurance – Texas (Chartis) View
Certificate Number: 28261132652 118680 Aon Risk Services, Inc. of Michigan 03/09/2012 Certificate of Insurance View
Certificate of Insurance No. 101 Rev. Date 04/01/2016 S622788 Austin Independent School District 05/12/2016 Austin Independent School District Certificate of Insurance View
Certificate of Insurance No. 102 Rev. Date: 04/17/2012 119548 Austin Independent School District 04/27/2012 AISD Project No. Certificate of Insurance View
Certificate of Insurance No. 103 Rev. Date: 08/21/2013 129619 Austin Independent School District 09/10/2013 AISD Project No. Certificate of Insurance View
Certificate of Insurance No. 104 Rev. Date: 04/17/2012 119548 Austin Independent School District 04/27/2012 AISD Project No. Contractor or Subcontractor Certificate of Insurance View
CGL309B-TX (02/12) 119075 American Home Assurance Company 04/02/2012 Certificate of Commercial Liability Insurance – Texas (Chartis) View
CGL309-TX (02/12) 119075 American Home Assurance Company 04/02/2012 Certificate of Commercial Liability Insurance – Texas (Chartis) View
CI CW 01 01 14 S23071 Allstate Insurance Company 06/30/2015 Certificate of Insurance - Commercial View
CI CW 02 01 15 S17719 Allstate Insurance Company 05/05/2015 Certificate of Insurance - Commercial View
CI TX 01 10 117960 Allstate Insurance Company 01/27/2012 Certificate of Insurance - Commercial View
CI TX 02 01 10 117961 Allstate Insurance Company 01/27/2012 Certificate of Insurance - Commercial View
CI TX 02 01 10 117999 Allstate Insurance Company 01/28/2012 Certificate of Insurance - Commercial View
CI TX 03 01 10 117961 Allstate Insurance Company 01/27/2012 Certificate of Insurance View
CI TX 03 01 10 117999 Allstate Insurance Company 01/28/2012 Certificate of Insurance View
CI TX 06 01 10 117961 Allstate Insurance Company 01/27/2012 Certificate of Insurance - Condominium View
CI TX A02 10 11 117959 Allstate County Mutual Insurance Company 12/29/2011 Texas Certificate of Insurance View
COI (1/12) 118701 Advocate, MD Insurance of the Southwest Inc. 02/13/2012 Certificate of Insurance Advocate, MD Insurance of the Southwest Inc. Claims Made Physicians and Surgeons Liability Insurance Policy View
Condo MOI 01-23-12 118597 Arthur J. Gallagher Risk Management Services, Inc. 02/13/2012 Memorandum of Insurance View
CSME&O 05252017 S641813 Anco Insurance Managers, Inc. / Common Sense Markets 10/10/2017 Errors & Omissions Statement of Coverage View
DD FORM 2400, Jan 2008; DD FORM 2400 (Back), Jan 2008 119075 American Home Assurance Company 04/02/2012 Civil Aircraft Certificate of Insurance View
DI706-1 118313 Allstate Insurance Company 03/07/2012 Certificate of Insurance View
DI706-1 118313 Allstate County Mutual Insurance Company 03/07/2012 Certificate of Insurance View
DI706-1 118313 Allstate Fire and Casualty Insurance Company 03/07/2012 Certificate of Insurance View
DI706-1 118314 Allstate Insurance Company 03/07/2012 Certificate of Insurance View
DI706-1 118314 Allstate County Mutual Insurance Company 03/07/2012 Certificate of Insurance View
DI706-1 118314 Allstate Property and Casualty Insurance Company 03/07/2012 Certificate of Insurance View
DI706-1 118324 Allstate County Mutual Insurance Company 03/07/2012 Certificate of Insurance View
DI706-1 118324 Allstate Property and Casualty Insurance Company 03/07/2012 Certificate of Insurance View
DI706-1 118324 Allstate Indemnity Company 03/07/2012 Certificate of Insurance View
FedEx Cessna 08211 128361 Aon Risk Services Southwest, Inc. 08/22/2013 Certificate of Insurance No. View
FedEx Main 08211 128361 Aon Risk Services Southwest, Inc. 08/22/2013 Certificate of Insurance No. View
Form: COMA1 - E: 0215 s15024 AirSure Limited, LLC 02/10/2015 Certificate of Aviation Insurance View
Form: GLAP1-E: 0215 s17281 AirSure Limited, LLC 04/01/2015 Certificate of General Liability Insurance View
Form TX COI 01 (Rev 07/2017) S643767 Alliant / John F. Throne & Co. (a division of Alliant Insurance Services, Inc.) 08/15/2017 Certificate of Insurance - Aircraft physical damage View
Form TX COI 02 (Rev 07/2017) S643769 Alliant / John F. Throne & Co. (a division of Alliant Insurance Services, Inc.) 08/15/2017 Certificate of Insurance - Aircraft Liability Coverage View
Form TX COI 03 (Rev 07/2017) S643770 Alliant / John F. Throne & Co. (a division of Alliant Insurance Services, Inc.) 08/15/2017 Certificate of Insurance - Aircraft Liability Coverage View
Form TX COI 04 (Rev 07/2017) S643732 Alliant / John F. Throne & Co. (a division of Alliant Insurance Services, Inc.) 08/15/2017 Certificate of Insurance - Aviation Commercial General Liability Coverage View
Form TX COI 05 (Rev 07/2017) S643766 Alliant / John F. Throne & Co. (a division of Alliant Insurance Services, Inc.) 08/15/2017 Certificate of Insurance - Aircraft physical damage View
Form TX COI 06 (Rev 07/2017) S643761 Alliant / John F. Throne & Co. (a division of Alliant Insurance Services, Inc.) 08/15/2017 Certificate of Insurance - Professional Liability (Claims Made Coverage) View
G 3000 07 16 S638483 Allied Property and Casualty Insurance Company 04/05/2017 Certificate of Liability Insurance View
GLD30ATT-TX (02/12) 119075 American Home Assurance Company 04/02/2012 Certificate of Insurance Attachment – Texas (Chartis) View
GLD30B-TX (02/12) 119075 American Home Assurance Company 04/02/2012 Certificate of Insurance – Texas (Chartis) View
GLD30HK-TX (02/12) 119075 American Home Assurance Company 04/02/2012 Certificate of Insurance – Texas (Chartis) View
GLD30-SCH/LIMITS (3/10) 119075 American Home Assurance Company 04/02/2012 Chartis Aerospace Insurance Services, Inc. View
GLD30-SCH/V2 (4/10) 119075 American Home Assurance Company 04/02/2012 Chartis Aerospace Insurance Services, Inc. Attachment to Certificate of No. View
GLD30-SCH/V3 (5/10) 119075 American Home Assurance Company 04/02/2012 Chartis Aerospace Insurance Services, Inc. Attachment to Certificate of No. View
GLD30-SCH (4/10) 119075 American Home Assurance Company 04/02/2012 Chartis Aerospace Insurance Services, Inc. Attachment to Certificate of No. View
GLD30-TX (02/12) 119075 American Home Assurance Company 04/02/2012 Certificate of Insurance – Texas (Chartis) View
LAD30B-TX (02/12) 119075 American Home Assurance Company 04/02/2012 Certificate of Insurance – Texas (Chartis) View
LAD30-TX (02/12) 119075 American Home Assurance Company 04/02/2012 Certificate of Insurance – Texas (Chartis) View
MBACRT01 (12/10) 118479 American Modern Lloyds Insurance Company 01/30/2012 Certificate of Liability Insurance View
n/a 117898 Allied Property and Casualty Insurance Company (Nationwide) 12/29/2011 Certificate of Insurance (Nationwide) View
n/a 117899 Allied Property and Casualty Insurance Company (Nationwide) 12/29/2011 Certificate of Insurance (Nationwide) View
N/A 120970 Alamo Recycle Centers 07/03/2012 Alamo Recycle Centers Standard Form Certificate of Insurance for Closure, Post Closure or Corrective Action View
NOL30B-TX (05/12) 124136 American Home Assurance Company 12/18/2012 Chartis Aerospace Insurance Services, Inc. Certificate of Insurance - Texas View
NOL30-TX (05/12) 124136 American Home Assurance Company 12/18/2012 Certificate of Insurance - Texas (Chartis) View
NOLAD30B-TX (02/12) 119075 American Home Assurance Company 04/02/2012 Certificate of Insurance – Texas (Chartis) View
NOLAD30-TX (02/12) 119075 American Home Assurance Company 04/02/2012 Certificate of Insurance – Texas (Chartis) View
NOP30B-TX (02/12) 119075 American Home Assurance Company 04/02/2012 Certificate of Insurance – Texas (Chartis) View
NOP30-TX (02/12) 119075 American Home Assurance Company 04/02/2012 Certificate of Insurance – Texas (Chartis) View
OM191212 121391 Amica Mutual Insurance Company 07/10/2012 Certificate of Insurance View
PF-35479 (04/12) 118897 ACE American Insurance Company 05/07/2012 Underground Storage Tank Certificate of Insurance to Demonstrate Financial Responsibility State of Texas View
PF-35531 (01/12) 118897 ACE American Insurance Company 05/07/2012 Certificate of Insurance for Liability View
PU 00 86 01 12 125559 Amica Mutual Insurance Company 02/13/2013 Certificate of Insurance View
Quota AC 10 05 121261 Air-Sur, Inc. 07/03/2012 Certificate of Insurance View
Quota AC Leinholder 10 05 129218 Air-Sur, Inc. 09/03/2013 Certificate of Insurance View
Quota AC Owner 10 05 129218 Air-Sur, Inc. 09/03/2013 Certificate of Insurance View
Quota AP 10 05 121261 Air-Sur, Inc. 07/03/2012 Certificate of Insurance View
Reg Own 10 05 121261 Air-Sur, Inc. 07/03/2012 Certificate of Insurance View
Texas Marine Addendum February 2012 118388 Arthur J. Gallagher Risk Management Services, Inc. 02/21/2012 Marine Certificate of Insurance Addendum View
UE31B-TX (02/12) 119075 American Home Assurance Company 04/02/2012 Certificate of Insurance – Texas (Chartis) View
UE31-TX (02/12) 119075 American Home Assurance Company 04/02/2012 Certificate of Insurance – Texas (Chartis) View


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