REQUEST BUSINESS CERTIFICATE

United Insurance Service offers an online option to request a business certificate of insurance.

This option should only be utilized for existing business insurance policies and coverage. If you need to add business coverage, please use the policy change form or contact our office.

You may request a business certificate of insurance by completing the form on this page.

We will make every effort to respond to certificate requests received during business hours within 2 hours.

If you have any questions or need priority service, please contact our office.

Business Name*
Your Name*
First Last
Email*
Phone*
Policy Number
Certificate request*
- General Liability
- Worker's Comp
- Commercial Auto

Certificate Holder's Name*
First Last
Certificate Holder's Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Send certificate by*
- Email
- Fax
- Mail
Email
Fax
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Special Instructions

United Insurance Service

Mailing Address
United Insurance Service, Inc.
PO Box 367
Wayland, MI 49348-0367

Branch Location
United Insurance Service, Inc.
9830 – 100th St SE
Alto, MI 49302-9681

Contact Info
T: 616.454.5677
F: 616.454.5679
E: info@unitedinsuranceservicemi.com

Business Hours
Mon–Fri: 9am–5pm

REQUEST BUSINESS CERTIFICATE

United Insurance Service

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