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

  • Information about you

    (the nominator, if different from above)
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