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	Yes No
Other information such as job name, term period if not present term, etc. Optional
Submission Validation Required	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.

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