Gallina and Sons
1269 Washington Pike
Bridgeville, PA 15017

Phone: 412-221-7010
Fax: 412-221-7035
Toll Free: 800-711-1065

Hours of Operation
Mon-Fri 8:30am to 5pm
Saturdays and Evenings
By Appointment
Closed Sundays

Map & Directions
To our Office

Did You Know?

. . . Gallina and Sons specializes in the unique insurance needs of condominium associations, home
owner associations, co-operatives, apartment communities and their individual unit owners and tenants?
If your community is insured by us we may be able to save you hundreds of dollers a year on your auto and homeowner insurance!

Association Certificate Request Form

Use this form to request a certificate of insurance for associations and unit owners currently insured by this agency. The certificate will be sent promptly in the manor requested. This is no charge for this service.

Person Requesting Certificate

We must receive this information to complete your request. Please be accurate.

Today's Date
Required

Open the calendar popup.

First Name
Required

Last Name
Required

Company Name (If Applicable)
Optional

Day Time Phone Number
Optional

Fax Number
Optional

E-Mail Address
Required

Reason For Request
Required

select

Preferred Method of Delivery
Required

select

Association Information

Name of Association
Required

Location
Required

select

Property Management Company
Optional

Unit Owner / Borrower Information
Unit Owner / Borrower Name Required Unit Owner / Borrower Name is required.
Additional Unit Owner / Borrower Name Optional
Property / Association Address Required
Additional Property / Association Address Optional
City Required City is required.
State Required State is required.
ZIP / Postal Code Required Input Required Please enter a valid Postal code.

Certificate Holder / Mortgagee (If Applicable)

Certificate Holder / Mortgagee Name
Optional

Additional Certificate Holder / Mortgage Name
Optional

Address
Optional

Additional Address
Optional

Name Extension
Optional

select

City
Optional

State
Optional

Zip Code
Optional

Loan Number
Optional

Comments or Special Conditions Optional
Enter Validation Code Required

Important Notice
Any submissions or payments made via this website do not constitute a binding agreement to your policy or coverages. Changes and payments to policies are not effective or binding until you, or any party involved, receive official notice from either your insurance agent, or your insurance company. If you have any questions, please feel free to contact us.

Per the terms of our online privacy policy we will not resell your information to any third-party.

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