Inland Marine Change - Brown & Brown Insurance of MN, Inc.

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530 West Pleasant Street, Suite 100
Mankato, Minnesota 56001
Phone (507) 388-2010

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Inland Marine Change Request
Your Name
Company
Phone Number
Fax Number
Email Address
Effective Date
Add or Delete?
Year
Type
Model
Serial #
Amount of Insurance
Loss Payee
Address 1
Address 2
City, State, Zip
Misc Info/Questions
Should be Empty:

* Please Note: Coverage cannot be assumed to be bound without confirmation from a licensed agent. A representitive from Brown & Brown will be in contact with you shortly to finalize any changes or cancelations.

Inland Marine Change Request