Supple-Merrill & Driscoll, Inc.

  Insurance Agents and Brokers | Since 1923

  

Client Services    CLaims & Payments, Certificates, POLICY CHanges, Company Ratings, and More

For your convenience, we have provided some client services online:
Claims & Payments Certificates of Insurance Policy Endorsements	Company Ratings Downloads Insurance Glossary

Certificates of Insurance	Top
Certificates of Insurance are used to provide vendors, locations and other interested parties with proof of insurance.  The Certificate of Insurance is also used to name designated parties as "Additional Insured" or "Loss Payee."  These documents are available to those who have already applied for and purchased insurance coverage for their event or project.
After completing the form below, please submit, and we will promptly issue the certificates upon receipt.  Sorry, blank Certificates of Insurance cannot be issued.
Or, if you prefer, click here to submit information for multiple Certificates of Insurance.
( indicates required information) Client Information Contact: Company: Project/Event Name: Email: Certificate Holder Information Contact: Organization / Company / Individual: Street: City: State/Province: < select > Alabama Alaska Alberta Arizona Arkansas British Columbia California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New York Newfoundland North Carolina North Dakota Northern Mariana Island Northwest Territories Nova Scotia Ohio Oklahoma Ontario Oregon Pennsylvania Prince Edward Island Quebec Rhode Island Saskatchewan South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Yukon Territory Postal Code: Country: < select > United States Canada Phone: Fax: Email: Certificate Holder's Interest: < select > City or Government Entity Equipment Rental Houses Film/Permit Office Guild/Union Individual Location (Commercial/Retail Site) Location (Private Individual) Other Payroll Company Production Company Studio/Network Vessel Owner Required Wording: < select > Additional Insured Loss Payee Additional Insured & Loss Payee Proof of Insurance Custom Wording   If Custom Wording:

Policy Changes	Top
Existing policyholders may request to endorse their policy online.
( indicates required information) Client Information Contact: < select > Quote Policy Number: Email: Policy Endorsement Information Endorsement Type(s): Policyholder Name Change   Policyholder Address Change   Add Line of Coverage   Increase Limits   Add/Remove Equipment on Schedule   Other   (select all that apply)   Please describe endorsement request:

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