Insurance and W-9

DOWNLOADABLE FORMS AND CERTIFICATE OF INSURANCE

Click the links below to download forms

Standard Certificate of Coverage May 2014 – May 2015
W-9 form (updated for 2014)

Fill out the form below to customize a certificate of insurance

Please note:

Amendment of cancellation clause on the certificate (Acord 125 form) is not supported.
10-day notice of cancellation applies to all certificates.
Orig. 6-10-08. Property of Knight Crockett Miller Insurance Group, 22 N. Erie St., Toledo, OH 43604.

*** Disclaimer ***
Filling out this form does not guarantee that GPRS insurance will meet all requirements. This is simply a request form.