Select type of policy change: * Change an address Change a limit of coverage Add a coverage Delete a coverage Add or delete a mortgagee, additional insured or loss payee
Complete this section for all changes:
Policy number: *
Policy holder: *
Proposed effective date of change: *
Agency name: *
Individual submitting this change request: *
Email address: *
Fax number: *
ProHost USA Inc.
4500 Park Glen Road
Minneapolis, MN 55416
Phone: (952) 922-2404
Fax: (952) 922-5423
Toll Free: (888) 968-6863
E-Mail: info@prohostusa.com
MN Agency License #7888
