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CONTRACTORS CERTIFICATE OF INSURANCE REQUEST

 

  • Date Format: MM slash DD slash YYYY
    please format as: mm/dd/yyyy
  • Certificate Holder Information

  • Email preferred
  • 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. RogersGray 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.