Location Certificate Request

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Location Certificate Request

Your Information

First(*)

First Name

Last(*)

Last Name Required

Business/dba

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Phone

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Fax

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Email(*)

Valid Email Required

Homeowners Insurance Policy #

Policy Number Required

Please Note: Your submitted changes do not take effect immediately. An Aloha Customer Service Representative will review and implement policy changes, and will contact you for additional information if necessary.

About your Landlord

Landlord Name/Business/dba(*)

Landlord Name Required

Phone

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Fax

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Email Address

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Landlord Address

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Address Line 1

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Address Line 2

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City

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State

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Zip Code

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Is your landlord to be an "Additional Insured" on your policy?

Yes

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Please Note: Naming your landlord as an additional insured will increase your premium.

Please choose the desired delivery method

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Any special instructions for the Aloha Staff

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75-5931 Walua Road
Kailua-Kona, Hawaii 96740
Phone: 808-334-0044

Toll-Free: 800-483-0333

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