Phone: (410) 871-4400 Fax: (410) 239-2878 Mailing Address: Passauer & Miller Ins., Inc. Po Box 360 Manchester MD 21102 Location: 3215 Main st. Manchester MD Certificate of Insurance Request   Insured Information Insured Name   dba or Business Name   Policy Number   Certificate Information Certificate Holder Name   Certificate Holder Street Address 1   Certificate Holder Street Address 2   Certificate Holder City, State, Zip   Certificate Holder Phone Numbers  Voice    Fax Is Certificate Holder requesting to be named an additional insured?   Yes No How do you want certificate delivered?   Mail Fax