Request a certificate of insurance

Need proof of insurance for a landlord, lender or job site? Send the details below and we’ll email the certificate, normally the same business day.

Request a Certificate of Insurance

For clients of John J. Lawless Insurance Agency. Start with the email address we have on file for you.

Your email address

We use this only to confirm you are a client and to send the certificate back. Nothing is stored on this page.

Certificate Request

Thanks — we found your email on file.

We don't see that address on file. You can still send the request — we'll confirm who you are before the certificate goes out. If you're not a client of ours, please contact your own agent instead.

You

Named insured (business name as it appears on the policy)

Your name

Phone (optional)

Certificate holder — who needs to receive it

Holder name

Address

Address line 2 (optional)

City

State

ZIP

Special wording

Only tick what the holder actually asked for. Some of these need an endorsement on your policy and may carry a premium — we'll tell you before anything is issued.

Additional insuredThe holder is named on your liability policy. Waiver of subrogationWe give up the right to recover from the holder. Primary & non-contributoryYour policy pays first, before theirs.

Details

Description of operations / project (goes in the remarks box)

Needed by

Send the certificate to

Anything else

Certificates are normally issued the same business day. Questions: LawlessAgency@Gmail.com

Request sent

Thanks — it's in. We'll email the certificate to you, normally the same business day. If you need it sooner, reply to the confirmation or write to LawlessAgency@Gmail.com.

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