Request Certificate2017-12-21T00:51:36+06:00

Certificate of Insurance Request

You are welcome to request a certificate of insurance via our online form below.  However, please note that requests received via our website do not constitute a binder of coverage nor has coverage been amended until you have spoken with a BenTec Insurance team member.  If you are making this request as a third-party, please know that we will need to confirm authorization with our client before providing confirmation of coverage.

Our agency team may be reached at 580.256.9918.

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Certificate Holder

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Policyholder/Named Insured

Individual Requesting Certificate

Please reference any Additional Insureds, Job Descriptions, or Waiver of Subrogations below along with any additional information you would like to list.

Call Us in Tulsa (918-227-1500) or Woodward (580-256-9918)
We Are Always Here To Help And To Answer Any Of Your Questions!