Secured by SSL

Certificate of Insurance


To request that C. T. Lowndes & Company send a Certificate of Insurance for liability, workers compensation, or commercial automobile insurance, please complete the following. All fields must be completed before your request can be submitted. Certificate of Insurance will be processed during our normal business hours, after hours will be handled the next business day. Thank you for doing business with our agency.

First, please identify yourself:
First Name
Required
Last Name
Required
Street
Required
City
Required
State
Required
ZIP / Postal Code
Required
Primary Phone Number
Required
E-Mail Address
Required
Your Business's Name
Required
To whom do you want the certificate of insurance sent to?
Business's Name
Required
Contact Person
Required
Business Mailing Address
Required
Business Phone Number
Required
Business Fax or Email Address
Required
Does the certificate holder require additional insured status?
Optional

Other information such as job name, term period if not present term, etc.
Optional
Submission Validation
Required
CAPTCHA
Change the CAPTCHA codeSpeak the CAPTCHA code
 
Enter the Validation Code from above.
Important Notice
Any submissions or payments made via this website do not constitute a binding agreement to your policy or coverages. Changes and payments to policies are not effective or binding until you, or any party involved, receive official notice from either your insurance agent, or your insurance company. If you have any questions, please feel free to contact us.

Per the terms of our online privacy policy we will not resell your information to any third-party.
© Copyright. All rights reserved.
Powered by Insurance Website Builder