Wasserman & Associates
1029 56th Street
Sacramento, CA 95819
Attn: Scott
Phone: (916) 739-0254
Fax: (916) 739-0434
E-mail
scott@wassermanins.com
Insured's Name and Address:
Insured's Phone
and Fax
Automobile Liability:
Excess Liability:
Workers Compensation:
Job Number:
Job Description:
Certificate Holder:
Additional Insured?
Days Notice for Cancellation?
Special Instructions: