Client Center

Request a Certificate of Insurance

To request a certificate of insurance from WBA, please fill out the form below.

* Required


The name of the business or customer that is insured by WBA






The name of the company or individual that is requesting the certificate of insurance






Additional Insured Information:

Yes
No

Additional insured status for ongoing operations
Additional insured status for completed operations
Primary non-contributory
Waiver of Subrogation for Workers Compensation
Waiver of Subrogation for General Liability


Yes
No
If yes, please select preferred communication method:

Yes
No
If yes, please select preferred communication method:


Please be advised that coverage cannot be bound or changed by submission of this on-line request. Insurance coverage or policy changes will be effective only when confirmed by a WBA agent.