Make a CHANGE to your Auto Insurance

Request a Certificate of Insurance

Catawba Valley Insurance Agency now offers you the ability to make changes to your auto insurance online using the form below. Contact from an agent will confirm your changes.

General Information
Insured Name:
Phone Number:
Email Address:
Policy Number:
Purchase/title date:	Mo Day Year
Sold/tags turned in date:	Mo Day Year
Vehicle Information
Vehicle 1	*Add or delete: Add Delete
	* Make: *Year: *Model: *Anti-Lock Brakes Yes No *Vehicle Identification Number: *Primary Driver Name: *Vehicle Usage: Pleasure Commute *If commuting, number of miles one way: *If commuting, number of days per week: *Annual Mileage: (average is 10-15,000) *Airbags: Driver Passenger Side All *Anti-theft device: Active Passive *Name on Vehicle Title: Lienholder Name: Lienholder Address:
Vehicle 2
	* Make: *Year: *Model: *Anti-Lock Brakes Yes No *Vehicle Identification Number: *Primary Driver Name: *Vehicle Usage: Pleasure Commute *If commuting, number of miles one way: *If commuting, number of days per week: *Annual Mileage: (average is 10-15,000) *Airbags: Driver Passenger Side All *Anti-theft device: Active Passive *Name on Vehicle Title: Lienholder Name: Lienholder Address:
Coverages - Please select the coverages you would like on your quote:
Liability:	Keep current coverages Make changes below
Change Bodily Injury:	$50,000/$100,000 $100,000/$300,000 $250,000/$500,000
Change Property Damage:	$50,000 $100,000
Change Medical Expense:	$1,000 $2,000 $5,000 $10,000
Change Uninsured/Underinsured Motorist Bodily Injury:	$50,000/$100,000 $100,000/$300,000 $250,000/$500,000
Change Uninsured/Underinsured Motorist Property Damage:	$50,000 $100,000
Vehicle 1:	other coverages
	Comprehensive Deductible:N/A $0 $100 $250 $500 $1000 Collision Deductible:N/A $100 $250 $500 $1000 Rental Reimbursement:15/$450 30/$900 Towing & Labor $50 $100
Vehicle 2:	other coverages
	Comprehensive Deductible:N/A $100 $250 $500 $1000 Collision Deductible:N/A $100 $250 $500 $1000 Rental Reimbursement:15/$450 30/$900 Towing & Labor $50 $100
Additional coverage needed and/or additional comments:
I understand that NO changes to my policy or coverage are bound by submitting this online Policy Change Request. This change request will be considered bound ONLY upon confirmation from my CVI agent. I have read and agree with the above. (Box must be checked before request is sent)