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McDaniel - Whitley, Inc
Certificate of insurance request
Which do you need?
Certificate of Insurance Only
Certificate of Insurance w/ Additional Insured Endorsement
Method of Delivery
Regular Mail - USPS
Hold for Pickup
Overnight - FedEx
Overnight - UPS
Email - Scan
Delivery - Call to arrange
Other-Specify in Comments
Name & Address of Certificate Holder
What is this certificate holder's insurable interest to you as named insured (i.e., landlord, permit, for job, etc.)
What is the Additional Insured's relationship to job being performed? (i.e. Owner, managing agent, lessor, general contractor, etc.)
Give complete description of job, and job location
Yes, Please Service My Account. I Understand that NO COVERAGE IS BOUND on insurance changes until confirmed IN WRITING BY OUR AGENCY.
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