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Equipment Change Request

Name: Preferred Insurance
Address: 4100 Monument Corner Dr, Fairfax, VA, 22030, US
Telephone: (703) 359-5910

Date

Name of Company Insured

Contact Name

Contact Phone

Contact Email

Effective Date of Change

Equipment Type? Leased or Purchased

Date of Purchase

Vehicle Description

Year

Make/Model

Model ID/ Serial No.

Description:

ID/ Serial No.

Delete the equipment described above?

Yes

Add the equipment described above?

Yes

Cost New?

Does the new equipment stay on the premises?

Yes

Loss Payee

Full Name

Street Address

City/State

Zipcode

Please fax any additional information or the police report to our office at 703-359-5915. Disclaimer: Communications to this insurance agency by electronic mail or voice mail CANNOT be considered as binding or otherwise effective for ANY insurance protection/policy coverage. Our office will contact you via e-mail to confirm any information sent and please look for the policy change endorsement to follow. If you do not receive this endorsement from the insurance carrier, contact your agent immediately. Thank you.

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Customer Reviews

 5/5

Ms. Shawna Renea was most helpful, she explained my policy to me and everything...

Antenice L

 5/5

For more years than I can recall Preferred Insurance has insured my home and...

Paul D

 5/5

When our Lansdowne Woods management team decided to go with Preferred Insurance...

Esther W

 5/5

Shawna made changes to our auto policy and provided a quote for homeowners...

Hugh L

 5/5

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Equipment Change Request