The Undergradaute Student Association Logo

printout letterhead



Certificate of Insurance Request

This form is intended to provide Undergraduate Student Association recognized clubs and organizations the ability to request Certificates of Insurance when required by vendors.

Submitting this form is a request, it does not guarantee that SA can provide this certificate.

 

Invalid Input
Invalid Input
Please choose your club from the list!



Invalid Input
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Invalid Input


COI Organization Info

Please enter the information below for the organization that requires the Certificate of Insurance.


Organization 1:

Invalid Input
Invalid Input
Invalid Input
Invalid Input