Request a Certificate

A Certificate of Insurance is often requested by vendors, clients, contractors, and other entities who require third-party verification of insurance. At Swingle Collins, we make the process quick and convenient. You can request a certificate at any time by filling out the form below, or by calling our office at 972-387-3000.

Insured's Info

Insured's Full Name

Insured's Email Address

Insured's Phone

Insured's Fax Number

Please Note: Many Banks Require a Fax for Confidential Information

Insured's Address 1

Insured's Address 2

Insured's City

Insured's State

Insured's Zip

Insured's Country

Holder's Info

Holder's Full Name

Holder's Email

Holder's Phone

Holder's Fax Number

Please Note: Many Banks Require a Fax for Confidential Information

Holder's Address 1

Holder's Address 2

Holder's City

Holder's State

Holder's Zip

Holder's Country

Please List Any Additional Insureds, Separated by a Comma

Please Include Any Additional Details in the Space Below

Will you be sending sample certificates? Yes No I'm not sure

These can be scanned and emailed to services@swinglecollins.com.

*Required