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Please fill out this form to request a certificate of insurance.

Insured Making Request:
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Date:
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Address:
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City:
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Zip Code:
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Recipient Information
Name:
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Address:
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City:
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State:
 *
Zip Code:
 *
Attention:
Fax Number:
Work Being Performed:
 *
 
Certificate Information
Auto
Workers Comp
Equipment
General Liability
Umbrella
Builder's Risk
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If YES Specify which policies and give details below:
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Please note that completion of the above request for information does not constitute the purchase of insurance. No coverage may be added, changed or bound as a result of submitting this request for information or quotation of insurance. All coverage must be confirmed by the agency in writing subject to an acceptable signed application meeting the underwriting guidelines of the Insurance Company.
Larry Johnson Insurance & Financial Services is licensed in the state of Florida.

No solicitation of insurance is being made outside of this state.

Hurricane Season begins June 1.  There is a 30 day waiting period on Flood Insurance. 
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Click here if you would like us to contact you for a quote.  Please provide your name and preferred method of contact.  We will contact you within 24 hours.
Join our Preferred Client Program and we will automatically shop your insurance with our available carriers annually to find you the best rate and coverage available.
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Watts Dawson & Associates, Inc.
13008 N. 56 Street        1139 Professional Park Dr.   2086 Edgewood Dr.
Tampa, FL 33617          Brandon, FL 33511                Lakeland, FL 33803
Phone: 813-985-0349    Phone:  813-651-9660            Phone: 863-688-1439 
Fax: 813-989-3284         Fax: 813- 685-0424                  Fax: 863-682-4234
Email: office@wattsdawsoninsurance.com
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