Indemnity Intake
§ 00
Filer Contact
Where we reach you about this submission
§ 01
Principal(s)
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§ 02
Corporate Indemnitor(s)
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§ 03
Individual Indemnitor(s)
Add as many as neededAttestation
By submitting this form, the undersigned affirms that the information provided is true, complete, and accurate to the best of their knowledge. Submission of this information does not by itself constitute a binding indemnity agreement; execution of the underlying General Indemnity Agreement is required and will be furnished separately.
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Our contact info
For Overnight Deliveries:
Lexington National Insurance Corporation
11426 York Road, 2nd Floor
Cockeysville, Maryland 21030
Lexington National Insurance Corporation
11426 York Road, 2nd Floor
Cockeysville, Maryland 21030
All other Deliveries:
Lexington National Insurance Corporation
P.O. Box 6098
Lutherville, Maryland 21094
Toll Free Number:
888-888-2245
888-888-2245
In Maryland: 410-625-0800
Facsimile: 410-625-0865
After-hours phone: 443-642-0080
