W 19 form 2026

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The document is Form W-19, a certificate of insurance for Iowa warehouse operators, certifying that an insurance policy has been issued to cover fire and windstorm risks for products stored in a specified warehouse. It includes details about the insurance company, the insured party, policy numbers, and compliance with Iowa Code Section 203C.15. The form also stipulates that the insurance company must provide a duplicate original of the policy upon request by the Department of Agriculture.

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Click ‘Get Form’ to open the W-19 form in the editor.
Begin by entering the Iowa Warehouse License Number in the designated field. This is crucial for identifying your warehouse.
Next, fill in the name of the Insurance Company and its home office address. Ensure accuracy as this information is vital for verification.
Input the Name of Insured and Policy Number, along with the effective dates of coverage. This section confirms who is covered under the policy.
If applicable, indicate if this policy replaces any previous one by providing the number and name of the replaced policy's insurance company.
Complete details regarding the location of the warehouse, total limits of liability, kind of insurance (e.g., Fire, Windstorm), and limits provided by the policy.
Finally, ensure that an authorized company representative signs and dates the form at the bottom before submission.

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