(On F Drive)
Urban Insurance Agency
800 North Wells
Chicago, Illinois 60610
800-680-0707
Date ______________
_
_
_
Please Contact Us
Regarding Proof of Prior Insurance.
Dear M____________________,
We tried to reach you by phone, but have been unsuccessful.
We are in need of additional information in order to start insurance
coverage for you.
Please mark down the name of your prior Insurance Company
in the space below, and send a photo copy of that policy.
Top of Form
Proof of prior insurance_____________________________________
Bottom of Form
Top of Form
You can fax this information back to us at 312-664-7193
Sincerely
Larry Lubell
Urban Insurance Agency
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