Related Page
Request for Insurance Certificate
The most frequent insurance related request that clubs receive is for a certificate of insurance - generally to prove that you have proper coverage or sometimes to include a third party (like the town or city) as being an additional insured for the event. You can obtain this by completing the form at left and faxing or emailing it to our broker (see below) at least 14 days prior to needing it. You may use either the word or the pdf version of the form.
Liquor Service
If your event is to include the serving of liquor, you should fill in the liquor questionnaire and fax or email it to our broker (see below) at least 14 days prior to the event. You may use either the word or the pdf version of the form.
Our broker is:
The most frequent insurance related request that clubs receive is for a certificate of insurance - generally to prove that you have proper coverage or sometimes to include a third party (like the town or city) as being an additional insured for the event. You can obtain this by completing the form at left and faxing or emailing it to our broker (see below) at least 14 days prior to needing it. You may use either the word or the pdf version of the form.
Liquor Service
If your event is to include the serving of liquor, you should fill in the liquor questionnaire and fax or email it to our broker (see below) at least 14 days prior to the event. You may use either the word or the pdf version of the form.
Our broker is:
Kelsey Schaafsma
Registered Insurance Broker
Commercial Lines CSR and Rotary Program Administrator
Registered Insurance Broker
Commercial Lines CSR and Rotary Program Administrator
Phone: 519-863-2014
Fax: 519-863-2015
Fax: 519-863-2015