Contact Information

To learn more about how you or your agent can receive a competitive quote from CompTrust AGC Mutual Captive Insurance Company, please contact Teresa Diamond  at 678-298-1889 or Lisa Wood at  678-298-1884.

To complete an application, please print the application below and return with 5 year loss runs via fax 678-298-1881 or send as an attachment via email to: tdiamond@affinityservicegroup.com or lwood@affinityservicegroup.com    

                                     Acord Workers Compensation App.pdf

       
For an All States quote, please provide the additional information from the multi-state check list below:

                              Multi State Check List (Information for Submission).pdf