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General Certificate of Insurance

To request Proof of Insurance, please complete all fields and submit this form. NOTE: Incomplete information could result in the delay of your request.

Insured Information
Certificate Information
Requester's Information
Handling Method
Required Coverages
Additional Insured
Loss Payee
PLEASE ALLOW A MINIMUM OF 48 HOURS TO PROCESS YOUR REQUEST. There will be a $20 processing fee for all Proof of Insurance. Rush requests will include a $25 processing fee.
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Contact Us

Capital City Insurance Services, LLC.

5901 Falls of Neuse Rd.
Suite 202
Raleigh, NC 27609

Telephone:  (919) 887-2415
Fax:  (919) 861-7810

Email Us

Hours of Operation:

8:30-5:30 Monday-Thursday
8:30-3:30 Friday
Evenings, Saturday & Sundays by appointment

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