Application Forms

Non Profit Certificate Request
Listed below are the new guidelines for when your organization needs to request a certificate of insurance. We will need all the information below in order to get the certificate from our broker. If we do not have all the information we will not be able to obtain a certificate for your event.

Request for certificates are process by THE DATE OF THE EVENT. If you need the certificate for a deadline prior to the event date please indicate the date you need the certificate by so then it will be processed accordingly.

We appreciate at least 7-10 days prior to the event date when requesting a certificate of liability.

In order to process a request for certificate we will need all the following questions answered.

CERTIFICATE REQUEST INFORMATION

Name
Email Address
Name of Organization

Date of Event
Name of Event
Event Location

Name and address of who is requesting the certificate of insurance if this is not your organization. This is the name and address of the organization that is requiring the certificate of insurance.

Do you need proof only or is the certificate holder requesting to be named as additional insured?

Note: If the certificate holder is requesting to be named as additional insured, we will need a copy of the vendor agreement or signed contract for the event. Please email this info to TLondon@KennelPak.com and include the full name of your organization in the email.

If they are requesting to be named as an additional insured we will need the wording that they want us to use on the certificate of insurance. Please provide the wording below.



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Endorsed By:
A.G.S.A.