Certificate of Insurance Request Form

ATTENTION: IF YOU HAVE A CONTRACT TO BE SIGNED, PLEASE EMAIL insurance@gsnorcal.org INSTEAD OF FILLING OUT THIS FORM
 
This form is used if a vendor or site you are working with requires a Certificate of Insurance from the council. For online facilities reservations such as (i.e. Civic Permits and Facilitron), email your request to volunteerexperience@gsnorcal.org directly. 
 
Certificates are EMAILED to the person requesting it, and should be forwarded to your facility or vendor upon receival. 

You should expect to hear back on your submission within 7-10 business days.  If you would like to follow-up please email:  insurance@gsnorcal.org

Person Making Request:

Certificate Issued To:

Is this request for: *
Certificate is proof of insurance for: *
Is Certificate Holder required to be named Additional Insured? *
Certificate Holder must be named Additional Insured because of a:

Electronic Signature


captcha

Published April 14th, 2014

* Please Note: Once you submit this form, you'll have the option to print the form contents on the following page.
Girl Scouting builds girls of courage, confidence and character that make the world a better place.  2014 Girl Scouts of Northern California