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| Question | Answer |
|---|---|
| Form Name | Pc326 Mdr 1 Form |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | certificate of mold damage remediation form, mold remediation invoice template, mold remediation invoice, mold |
Te x a s De pa rt me nt of I nsura nce
Property and Casualty Section – Personal and CommercialOf Lines Office
Mail Code
CERTIFICATE OF MOLD DAMAGE REMEDIATION
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SIGN APPROPRIATE CERTIFICATION
Mold Assessment Consultant License Holder Certification
ｸI hereby certify that based on visual, procedural and analytical evaluation, the mold contamination identified for this project has been remediated as outlined in the mold management plan or remediation protocol.
ｸI further certify with reasonable certainty that the underlying cause or causes of the mold that were identified for this project in the mold management plan or remediation protocol have been remediated. A copy of the written evaluation that forms the basis for my certification has been provided to the person named in this certificate.
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Mold Remediation Contractor License Holder Certification
ｸI hereby certify that I completed mold remediation on this project and will provide the mold remediation certificate to the property owner no later than the 10th day after the date of completion.
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Mold Assessment Consultant or Adjustor License Holder Certification
ｸI hereby certify that I have inspected the property described in this certificate and that based on my inspection I have determined that the property does not contain evidence of mold damage. A copy of the written evaluation that forms the basis for my certification has been provided to the person named in this certificate.
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License Holder Signature |
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PC326 |
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