NEBRASKA REAL ESTATE COMMISSION
CERTIFICATION OF COVERAGE UNDER NEB. REV. STAT. SECTION 81-885.55 
AND 299 N.A.C. CHAPTER 8


I hereby certify that the insurance company listed below has at least a "B+" rating
from the A.M. Best Company Insurance Rating Service and maintains an A.M. Best Financial
Size Category of Class VI or higher. I further certify that:
INSURED NAME
LICENSE IDENTIFICATION NUMBER
REAL ESTATE COMPANY NAME
ADDRESS
POLICY NO.
INSURANCE AGENT
ADDRESS
INSURANCE CO.
ADDRESS
POLICY DATES Effective           Expiration
SPECIFY WHETHER BLANKET OR INDIVIDUAL POLICY
is insured against claims resulting from real estate licensee's errors and omissions and the
above-referenced policy includes, at a minimum, the standards set forth in 299 N.A.C. 
Chapter 8 and the Nebraska Real Estate License Act.
It is further understood and agreed that coverage for the person(s) insured by this policy may not be
terminated, canceled, lapsed, or non-renewed, regardless of cause or reason, without the company having
provided the Director of the Nebraska Real Estate Commission with ten (10) days prior written notice.
Submission of this Certification of Coverage form verifies that all statements and information provided
herein are true and correct and may be used as necessary by the Nebraska Real Estate Commission
if furtherance of assuring compliance with the laws it regulates.
        
NAME OF INSURANCE REPRESENTATIVE                               DATE

TITLE