Certificate Request form
Certificate
If you currently have COMMERCIAL insurance with us you may request a certificate here or email us at request@duranteagency.com. If you need a evidence of insurance for your personal car please call the office at 702-366-0160
Your Name *
Your answer
Your company's name *
Your answer
Policy number
This will help us locate your policy but it is not required
Your answer
Are we adding a *
Select both if the cert holder needs to be additional as well
Required
Name of Additional or Holder if any
Your answer
Address of addition
Your answer
Special wording or instructions
Your answer
Some insurance policies will require additional premium to add a certificate holder or an additional insured. Once we have processed your request we will advise if any additional premium is required.
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