Skip to the content

Call Us Today (860) 274-0900

Import Insurance & Get Quote(opens in new tab)

Colonair Insurance Agency

Insurance Services
About
Support
Contact

Home > Support > Certificate of Insurance Request

Certificate of Insurance Request

General Information
Name of Insured*
Name or Company of Certificate Holder
Job Reference Number
Address of Holder
Street Address Address Line 2 City State ZIP Code
Holder Phone
Holder Fax
Your Name*
Contact Email*
Handling Method
- Fax
- Email
Required Coverages
Please Provide Copy of Insurance Requirements of Contract
- Auto
- Umbrella
- General Liability
- Equipment
- Workers' Compensation
- Builders Risk
General Liability Description
Need Endorsements for Waiver of Subrogation?
- Yes
- No
Need Endorsements for Primary Wording?
- Yes
- No
Loss Payee
- Yes
- No
Mortgagee
- Yes
- No
Additional Insured
- Yes
- No
Comments or Other Instructions
Attach File(s)
Drop files here or

Max. file size: 59 MB.
Please attach written request(s) and/or contracts received, if any.
Messaging Opt-In*
Do we have permission to text the phone number listed above?

Message frequency varies, reply STOP to opt out at any time.
- Yes! You can send me texts.
- No, do not text me.
Comments
This field is for validation purposes and should be left unchanged.

Δ

We Want Your Opinion!

Customer Reviews

RL

You can not find better customer service!!Reale L., Watertown, CT

JO

Excellent service and personalized attention.John O., Thomaston, CT

RW

Could not ask for a harder working group of professionals.Raymond W., Waterbury, CT

SB

Very knowledgeable and very efficient.Stephanie B., Waterbury, CT

KR

We highly recommend Colonair!Kimberly R., New Britain, CT

See All Reviews See All Reviews

About

About Us
Our Insurance Carriers
Customer Reviews
Insurance Blog

Insurance

Auto, Home, & Personal Insurance
Business Insurance
Life & Health Insurance
Propeller Bonds

Policy Service

Support
File A Claim
Online Billing & Payments
Policy Change Request
Annual Insurance Checklist

Contact

Colonair Insurance Agency

27 Siemon Company Drive
Suite 308E
Watertown, Connecticut 06795

Phone: (860) 274-0900

Fax: (860) 274-0938

Mon-Fri: 9:00am-5:00pm
Sat-Sun: Closed

Google Maps Logo (opens in new tab)Facebook Logo (opens in new tab)

Colonair Insurance Agency specializes in auto insurance, home insurance, business insurance, life insurance, health insurance, and employee benefits for all of Connecticut, including Watertown, Oakville, Waterbury, Southbury, Cheshire, Danbury, Woodbury, Southington, Naugatuck, Middlebury, Plymouth, Prospect, Thomaston, and Wolcott.

© Copyright 2025, Colonair Insurance Agency | Privacy Statement | Accessibility Statement | Login

Website Builder Platform(opens in new tab)