Home
Contact Us
About The Fund
History of the Fund
How The Fund Works
Fund Eligibility
Fund Structure
Board of Trustees
Member Services
Payroll Change
Request a Loss Control Visit
Final Premium Audit Worksheet
Request a Payroll Audit
Other Requests
Make a Payment
Resources
Newsletters
Webinars
Association Contacts
Request a Quote
Report A Claim
Newsletter Sign Up
Make a Payment
endorsed by
You are here :
Member Services
>
Request a Loss Control Visit
Register
|
Login
Request a Loss Control Visit
Please fill out the form below.
Fields marked with an asterisk (
*
) are required.
*
Member Number:
*
Name:
*
Location to Visit:
*
Contact Name at Location:
*
Email:
*
Reason for Visit:
1690 Watertower, Suite 500, East Lansing, MI 48823
800.686.6640 or 517.664.2770 | Fax: 517.664.2787
www.regency-group.com
Design & Hosting
by
Freshlook Solutions