Txdot certificate of insurance form 1950-2025

1. Click ‘Get Form’ to open the txdot certificate of insurance form 1950 in the editor.
2. Begin by filling in the 'Insured' section with your name and complete mailing address, including city, state, and zip code.
3. Enter your Vendor EIN Number (11 digits) and phone number in the designated fields.
4. For Workers' Compensation Insurance Coverage, provide the carrier name, phone number, and address. Ensure that it is endorsed with a Waiver of Subrogation in favor of TxDOT.
5. Complete the sections for Commercial General Liability Insurance and Commercial Automobile Insurance similarly, ensuring all required endorsements are included.
6. Fill out any additional insurance coverage details if applicable, following the same format as above.
7. In the Agent Certification section, enter the name of your insurance company and authorized agent along with their contact information. Ensure an original signature is provided.
8. Review all entries for accuracy before submitting via fax or email as instructed. Remember to follow up with originally signed forms if required.

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