Insurance Certificate Request
Requestor Name
*
Project Name
*
Project Specialist
*
Type to search
Additional Insured Information
Additional Insured Information
Please complete the following information for the “additional insured” party that has requested to be added to our policy or that requires evidence of insurance.
Name of Additional Insured
*
Address
*
City
*
Province
*
Postal Code
*
Reason for Request
*
e.g. Required for space rental or grant agreement. Or paste screenshot of insurance requirements from agreement
Location/Operation/Date of Event
N/A if insurance is required as part of grant agreement.
Comments/Special Instructions
Date Required (if applicable)
File Attachments (if applicable)
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