To obtain a quote, the following information is needed.

• Acord Application (click on link)
• Current Mod Worksheet
• Loss runs valued within 6 months of expiration for current year, plus 4 prior years
• Current financial statement (prior to binding)

If you have any questions or need assistance, please contact the underwriter, Amy Cook, at 1.800.252.5059, ext. 1216. You may email or fax your information to her at amy.cook@ccmsi.com or fax, 217.444.2498