Request General Liability Certificate of Insurance

Fill out the following form as completely as possible. Once you have completed the form, click the Submit button to send your information. Your request will be handled promptly.

Personal Information

First Name *

Last Name *

Company Name *

Street *

City *

State *

ZIP / Postal Code *

Primary Phone Number *

Alternate Phone Number

Fax #

E-Mail Address *

Policy Information

Policy Number *

Company Requesting your Certificate

Company Name *

Street *

City *

State *

ZIP / Postal Code *

Primary Phone Number *

Alternate Phone Number

Fax # *

E-Mail Address *

Submission Validation

Required

Important Notice
Any submissions or payments made via this website do not constitute a binding agreement to your policy or coverages. Changes and payments to policies are not effective or binding until you, or any party involved, receive official notice from either your insurance agent, or your insurance company. If you have any questions, please feel free to contact us.

Per the terms of our online privacy policy we will not resell your information to any third-party.

Insurance Websites Designed and Hosted by Insurance Website Builder

King Insurance Services will be Closed For walk in business until further notice

due to the COVID-19 outbreak

(phones will be answered during normal business hours).

If you need to file a claim please refer to your policy DEC page or ID Card.

If you need a quote, make a pmt. or basic policy services you can go to my website at

www.alexkingagency.com and select the appropriate button

(Policy Services, Get a Quote, or Make a Pmt.).

I apologize for any inconvenience this may cause.

Thank you Alex