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OFFICE ADDRESS
4299 Five Oaks Drive
Lansing, MI 48911

MAILING ADDRESS
P.O.Box 27067
Lansing, MI 48909-7067

TELEPHONE
1.800.968.5445
1.517.482.7900

FACSIMILE
1.517.482.1696

 

 

 

 

 

Request a Certificate of Insurance

To have a Certificate of Insurance mailed to you or a Certificate Holder, please complete all information below.
Type of Certificate:
Liability Workers' Compensation
Vehicle Home Owners / Renters


Insured (Requestor)
Named Insured:
Street:
City:
State: Zip Code:
Requestor's Name:
Telephone (with area code):
Email:


Certificate Holder (Recipient)
Named Insured:
Street:
City:
State: Zip Code:
Telephone (with area code):


 

 


Doing Business As "Nelson E. Gilroy/Capital Insurance Services" in the State of California

© Capital / Insurance Services Corporation • 2007• All Rights Reserved