Home
About Us
Our Companies
Testimonials
Insurance Coverage
Auto Insurance
Business Insurance
Commercial Property Insurance
General Liability Insurance
Commercial Auto Insurance
Worker’s Comp
Commercial Umbrella Insurance
Bonds
Life Insurance
For Individuals
For Businesses
Disability
Long Term Care
Homeowners Insurance
Other Personal Insurance
Boat & Watercraft
Specialty Vehicles
Umbrella Insurance
Flood Insurance
Services
Payment & Claims
Forms
Homeowners Insurance Change Request Form
Personal Auto Insurance Renewal Questionnaire
Request a Certificate of Insurance
Add a Driver (Commercial)
Add a Driver (Erie – Commercial)
FAQs
Resources
Contact
Lewis Insurance Referral Program
Request a Certificate of Insurance
Home
Request a Certificate of Insurance
Request a Certificate of Insurance
*
Contact Person
*
Email Address
*
Phone Number
*
Requesting Company Name
*
Email Address
*
Street
*
City
*
State
*
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Zip Code
*
Phone Number
*
Fax Number
*
Additional Information
Some companies request to be added to your policy as an additional insured. This will increase your premium. By selecting yes to the question below, you are authorizing the addition of the above company to your commercial general liability policy as an additional insured.
Is the requesting company to be named as an additional insured?
*
Yes
No
If the company requesting the certificate has a requirement not specified above please contact the office at 540-659-2121.
reCAPTCHA