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C L Butcher Agency
P.O. Box 5449
Knoxville, TN 37928
(865) 689-5482
Fax: (865) 689-5491

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Certificate or Proof of Insurance

We're glad to assist you in getting the appropriate Certificate of Insurance or Proof of Coverage to the requesting party. Simply give us the brief information requested below and we'll take care of the rest. Please be sure you give us all of the pertinent information about the Certificate holder so we can get to them what they are requesting.

* Required Fields Party completing this Certificate Request:   Name of Insured (person / company):   Named Insured Address:   Office Phone:   Mobile Phone:   *EMAIL Address:   How would you like for this Certificate of Insurance to be sent?:   Select One... Fax E-mail US Mail Name, Address, FAX or E-mail address of the Certificate holder:   Please give us any other information that we might need that would help to process your Certificate of Insurance request more accurately:   Please click the Send button only once.