Coffman & Farrar Insurance Group

Metro KC (913) 438-5900
Lawerence (785) 865-5800
More Contact Information

Office Address
128 S Chestnut
Olathe, Kansas 66061
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Kansas City: (913) 438-5900
Lawrence: (785) 865-5800

Request Certificates

Please fill out either of the forms below and an agent will be contacting you right away to confirm your request has been processed. Because of the importance of the information provided, and our concern for the privacy of our clients, we will acquire any potentially vital information over the phone.

Click on one of the certificate headings below to fill out our online request form...

Certificate Of Liability Insurance

The "Certificate Of Liability Insurance" is an important document that will allow the insured and/or policy holders proof of certain types of liability insurance.

Please Fill In The Fields Below
(Missing Field Information Will Be Required When Contacted)
* - indicates a required field

Personal Information:
Name Of The Insured: *(Business or Individual)
Street Address: *
City:	State: Zip Code:
Phone Number: *	Fax Number:
Email Address: *
Policy Number:
Insurance Information:

Certificate Holder: *
Street Address: *
City: *	State: * Zip Code: *
Type Of Insurance: *

Description Of Operations:

Evidence Of Commercial Property Insurance Certificate

The "Evidence Of Commercial Property Insurance Certificate" is another important document for business owners to provide to other interested parties (i.e. lenders, city municipalities, etc).

Please Fill In The Fields Below
(Missing Field Information Will Be Required When Contacted)
* - indicates a required field

Personal Information

Name Of The Insured: *
(Business or Individual)

Street Address: *

City: *

State: *

Zip Code: *

Phone Number: *

Fax Number:

Email Address: *

Policy Number:

Insurance Information

Certificate Holder: *
Loan Number:
Address: *
City:	State: Zip Code:
Fax Number: *	Holder Email:
Additional Interest:

(NOTE: These certifications are issued as a matter of information only and confers no rights upon the certificate holders. These certificates do not amend, extend, or alter the coverage afforded by the policies.)