Checklist for Kraft Lake Policies:

Premium Finance Agreement:

❏ Insured and Agent Signature/Date

❏Verify Insured Mailing Address

❏Insured's Email Address?

❏Insured's Phone Number?

Down Payment Authorization:
❏ Name of authorized check holder
❏ Check authorization amount
❏ Signature/date
❏ Fill out routing/account information or attach voided check
❏ Effective date request
❏ Optional monthly auto draft

Send Completed Forms to info@columbiapacificfinance.com or fax 877.679.0857


Please Note:
❏ CPF cannot bind coverage, only your underwriter is able to bind the policy
❏ If paying in full: Make checks payable to Kraft Lake Insurance Agency and mail to: PO Box 3278, Grand Rapids, MI 49501

 P. 206.686.0006        F. 877.679.0857        E. info@columbiapacificfinance.com

©2019 by Columbia Pacific Finance.