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Certificate Of Coverage - South Dakota Real Estate Commission - Real Estate Agent'S Errors & Omissions Insurance 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)

Certificate Of Coverage - South Dakota Real Estate Commission - Real Estate Agent'S Errors & Omissions Insurance Form