ACORD 22 Form Fillable – Intermodal Interchange Insurance PDF

Intermodal Interchange Certificate of Insurance

ACORD 22 (2016/03)

Property & Casualty

March 2016

2 page

PDF, Fillable PDF


An Acord 22 form is a legal document that serves as proof of the motor carrier’s insurance coverage. The Intermodal Equipment Providers (IEPs), Uniform Intermodal Interchange & Facilities Access Agreement participants, ports, Rail yards, and container leasing companies. It protects against financial loss caused by an accident during the movement of goods through cargo, ships, and trains. This form is important to confirm cargo and trailer liability interchange coverage, comply with UIIA requirements, and access intermodal facilities.

The usage of this acord form in the insurance industry provides the following benefits to the policyholder during the transportation process.


The Acord 22 intermodal interchange certificate of insurance streamlines the communication between insurance carriers, leasing firms, and transportation partners. It helps speed up agreements and contract approvals.

The accurate availability of the form prevents delays and disruptions in pickup or drop-off operations, ensuring a smooth transportation service.

It provides legal protection against disputes, audits, or claims involving insurance coverage.

The form helps the policyholder meet the insurance compliance requirements of the UIIA and intermodal equipment providers.


Contains the date, producer, and insurer’s information to streamline communication.

Includes additional insurer ID, types of insurance, policy number, effective and expiration date, and policy limits.

Records the details of the policy and additional remarks to streamline the communication.

Includes the company’s details, such as name, address, and contact number.

A prior notice must be sent to the policyholder to inform them of the policy cancellation before the expiration date.

The authorized representative of the insurance company must sign to validate the certificate.


  1. Write the issuing date of the certificate at the top.
  2. Mention the name, address, and contact number of the insurance agent or broker.
  3. Write the name, address, and contact number of the owner and additional insured.
  4. Mention the type of policy, number, effective date, expiration date, and policy limits.
  5. Write the description of the services included with additional remarks.
  6. Provide the name, address, and contact number of the policyholder.
  7. Refer to the cancellation clause as outlined in the insurance industry’s terms and conditions.
  8. Get the authorized representative’s signature to validate the certificate.

It includes general liability, automobile liability, cargo, trailer interchange, workers’ compensation and employers’ liability.

You may face legal complications and denied access to intermodal terminals, equipment, and ports.

The form reflects the policy period. You need to renew the certificate after the policy expires.

No, we ensure that we provide the latest Acord Certificate of Intermodal Interchange free of charge.

Individuals or transport companies, including trucking companies, motor carriers, and logistics providers, are involved in the intermodal operations.

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