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Certificate of Insurance Request
Please allow at least 2 business days for processing. If your venue has a "sample" certificate, please send to dcallen@williams-syndrome.org with the name of your event.
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Your Name
Your answer
Event name
Your answer
Type of event (3rd party fundraisers do not qualify for a COI)
Walk
Other:
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Event date
MM
/
DD
/
YYYY
Event location
Your answer
Holder address (if different from above
Your answer
General policy limits
Your answer
Automotive policy limits
Your answer
Workers comp policy limits
Your answer
Participant liability limit
Your answer
Additional insured endorsements
Your answer
Additional information
Your answer
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