The following form is for information purposes only. Please call Dale Feece/Customer Service at (574) 831-5010 ext 214 if you need to be named as a certificate holder.

IMPORTANT: The Certificate of Insurance above does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.