Centennial Insurance Agency Nomination Form

Alabama Retail Comp, the workers’ compensation self-insurance fund associated with the Alabama Retail Association, is seeking Alabama Centennial Insurance Agencies – insurance companies that have been doing business in Alabama for 100 or more years. The program recognizes century-old insurance agencies for their contributions to the state’s past, present and future. Alabama Centennial Insurance Agencies will be recognized at the Alabama Retail Day Luncheon in the fall. Any insurance agency that began in 1918 or before is eligible as an Alabama Centennial Insurance Agency. Agencies submitted will be contacted and asked to provide a brief history and other information about their business.

I am pleased to nominate the following insurance agency, which has been in operation for 100 years or more in Alabama, as an Alabama Centennial Insurance Agency
Company
Owner/Contact
Title
Address
Street Address City State ZIP Code
Phone
Fax
Email
Year Business Opened
Information about you
(the nominator, if different from above)
Name
First Last
Title
Address
Street Address City State ZIP Code
Phone
Fax
Email
Phone
This field is for validation purposes and should be left unchanged.

Alabama Retail Association

A Content Site

I am pleased to nominate the following insurance agency, which has been in operation for 100 years or more in Alabama, as an Alabama Centennial Insurance Agency

Information about you

What is Alabama Retail Comp?

The greatest benefit of Alabama Retail Association membership is the workers’ compensation coverage you can choose to take advantage of through the association’s affiliate, Alabama Retail Comp.