Certificate of Insurance Request

General Information

State

Handling Method

Fax

Required Coverages

Please Provide Copy of Insurance Requirements

Auto

Umbrella

General Liability

Equipment

Workers' Compensation

Builders Risk

Need Endorsements for Waiver of Subrogation?

Need Endorsements for Primary Wording?

Loss Payee

Mortgagee

Additional Insured

Attach File(s)
Please attach written request(s) and/or contracts received if any. (If more than 3 docs need to be submitted please contact us.)

Attach File (1)

Attach File (2)

Attach File (3)

If you need to send more than 3 attachments please contact us or fax them.

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Customer Service

Dodge City, KS

AutoSure, Inc.

2600 Central Ave, Ste A
Dodge City, KS 67801
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Email: info@autosureinc.com

Phone: (620) 225-2200

Hours of Operation:

Mon-Fri: 9:00am-5:30pm
Saturday - By appointment
Sunday - By appointment

AutoSure, Inc.

150 Plaza Drive, Suite 306
Liberal, KS 67901
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Email: info@autosureinc.com

Phone: (620) 482-8114

Hours of Operation:

Mon-Fri: 9:00am-5:30pm
Saturday - By appointment
Sunday - By appointment

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