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19785 Crystal Rock Drive, Suite 301, Germantown, Maryland 20874

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(301) 428-4935

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Home > Policy Service Center > Certificate of Insurance Request

Certificate of Insurance Request

General Information
Name of Insured Company:
First Last
Name or Company requesting Certificate of Insurance:
Job Reference #/Loan #/Lease #:
Address of Holder:
Street Address Address Line 2 City State ZIP Code
Holder Phone:
Holder Fax:
Your Name:*
Contact Email Address:*
Handling Method:
- Fax
- Email
Required Coverages
Please provide copy of insurance requirements of contract:
- Commercial Auto
- Umbrella
- General Liability
- Equipment
- Workers' Compensation
- Builders Risk
General Liability Description:
Need Endorsements for Waiver of Subrogation:
- Yes
- No
Need Endorsements for Primary Wording:
- Yes
- No
Loss Payee:
- Yes
- No
Mortgagee:
- Yes
- No
Additional Insured:
- Yes
- No
Comments or Other Instructions
Attach File
Please attach written request(s) and/or contracts received, if any.
Max. file size: 59 MB.
Name
This field is for validation purposes and should be left unchanged.

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Customer Reviews

LT

Quote for you when police end and find the best, very helpful!Lucia T., Germantown, MD

HB

Great company!HoyMy B., Germantown, MD

BR

Faye is a great asset to the Klinger agency!Brandie R., Germantown, MD

MK

She is also great at keeping up with all my insurance needs.Molly K., Germantown, MD

A very professional team and definitely recommend to others.Priyesh P., Germantown, MD

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Klinger Insurance Group

19785 Crystal Rock Drive, Suite 301
Germantown, Maryland 20874

Phone: (301) 428-4935

Fax: (301) 428-4936

Mon-Thu: 8:00am-5:00pm
Fri: 8:00am-4:00pm
Sat-Sun: Closed

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Klinger Insurance Group Provides Auto/Car Insurance, Home Insurance, Business/Commercial Insurance, and Life Insurance to All of Maryland, Including Bethesda, Germantown, and Frederick.

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