Bc Certificate Of Insurance Form

Certificate of insurance request form if you are required to provide a certificate of insurance to a vendor contrac tor or other entity for any reason please supply the following information and fax or email this form to the office of risk management at 617 552 3357 or kathryn larner bc edu.

Bc certificate of insurance form. The certify to line should be filled in with the name of the organization company requesting proof of insurance. Frontcounter bc phone no 1 877 855 3222 within north america or 1 778 372 0729 outside of north america mailing address postal code contractor name contractor address postal code part 2 to be completed by the insurance agent or broker insured name address postal code operations insured provide details type of insurance. Per accident ea accident n a subr wvd addl insr. A copy of the terms.

When listing dates it is acceptable to list a span of dates. The form must be completed in full. Additional conditions are shown on page 2 of this certificate of insurance h0111 2009 12 page 2 of 2 notwithstanding any other terms conditions or exclusions elsewhere in the insurance policy s it is understood and agreed that the insurance. Both pages 1 and 2 are required for submission.

A certificate of insurance request form should be completed and submitted to the bc hockey office at least 7 10 business days prior to the start of the event. For instructions and assistance when completing this form hold your cursor over the fields of the form. This form can be found on the forms page of the website. If you require a copy of the bc certificate of insurance form please contact your permit clerk in the frontcounter bc office in either cranbrook kamloops prince george smithers or surrey and they will assist you.

Proof of insurance will only be accepted on a current bc certificate of insurance form that has been provided to you by your frontcounter bc permit clerk. Requesting a certificate of insurance. Province of british columbia certificate of insurance form fin 173 chapter 6 6 3 3 e 11 of the core policy and procedures manual cppm states that ministries must ensure the contractor s agent or broker completes and signs the province of british columbia certificate of insurance fin 173 ms word or fin 173 fillable pdf in compliance with the insurance requirements of the contract. This certificate of insurance does not constitute a contract between the issuing insurer s authorized representative or producer and the certificate holder.

This certificate of insurance form is applicable specifically for the ministry of transportation and infrastructure.