Journeay Insurance Agency, Inc.
8 West Main Street
Merrimac, MA 01860
978-346-8761
Fax 978-346-9620
Map & Directions
Staff Directory

We are located at the time and
temperature sign on Main Street
 

Same day registry service!
Same day license plates!
 MA RMV

Request a Certificate of Insurance

This page is intended for contractors only. If you are looking for assistance with any other business or personal insurance needs, please contact us.  To request a commercial Certificate of Insurance, please fill out the following form:
Date
Insured's Name
Email Address REQUIRED
Name of Certificate Holder
Street Address
City, State & ZIP Code
Job Name/Property Name
Location Address

Special Requirements

Certificate Holder
"Named Additional Insured"

 
(ISO Form CO 20 10 11 85)
 
30 Day Notice of Cancellation
10 Day Notice of Cancellation
Special Wording for Banks:
Their Successors and/or Assigns, ATIMA
ISO Form CG 25 03 11 85
Separate Aggregate Limit per Project

Additional Requirements

Special Forms to Attach
Additional Comments
 

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Last updated on Wednesday, August 10, 2011
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