Endorsement Request Agent Name(Required)Agency Name(Required)Agent Email(Required) Policy Number(Required)Insured Name(Required)Line of Business(Required)Type of Endorsement(Required)Address Changed ToMortgagee Name and AddressEdorsement Requestor Name and AddressVehicle Information (Changes to Business Auto, Motor Truck Cargo, etc.)If you have any questions or need assistance, please contact BIIA at 757-420-3022.NameThis field is for validation purposes and should be left unchanged. If the form does not display, you may be using an unsupported browser (such as Internet Explorer). We suggest updating your browser. Visit this site to update your browser. Request a Quote Make a Payment Report a Claim Report Builders Risk Loss History Request