Certificate of Insurance Request

Certificate of Insurance Request

  • Date Format: MM slash DD slash YYYY
    please format as: mm/dd/yyyy
  • Prepare a Certificate of Insurance to the following

  • Provide Project Specifications, Contractual Insurance Requirements and Example Certificates if available.
  • Please enter email, fax number or mailing address of recipient
  • Certificate will be mailed, faxed or emailed per your request.

    NOTE: Certificates for Workers Compensation policies written through the MA Workers Compensation Risk Plan must be issued directly by the insurance company wiriting the policy. Rogers & Gray will order the certificate which will be issed by the carrier within two (2) business days. A copy will be kept on file for the insured unless instructed otherwise. Certificate will be available within 24 hours.

Contact Us

434 Route 134
South Dennis, MA 02660

Phone: 508-619-4545

Fax: 877-816-2156

24 Hour Emergency Claims Center 866-709-8001


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