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Request for Letter of Insurance

Whenever you have a request from an outside organization for proof of insurance you need to complete the form below. If the request is part of a field trip we will need a copy of the CCF-798 in addition to this request. When you have completed the request form click the submit button. The original letter or insurance certificate will be mailed to the requesting organization. A copy will be emailed to you as well. If you have any questions please call 799-6496 x 5634.

Items marked with a * are required

Request for Letter of Insurance
Check all that apply

Auto Liability
General Liability
Property
Workers Compensation




Give specific details regarding the event that requires proof of insurance.




: am pm




: am pm


Allow at least 48 hours to complete request.







(xxx) xxx-xxxx













(xxx) xxx-xxxx






Event information, Field Trip Form (CCF-798), etc.