Certificate of Insurance (COI) Request Information

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To request an accurate Certificate of Insurance (COI) from the insurance agency (State Farm: steve@stevesandoval.com), please fill out the form below and reply:

 

1. Certificate Holder Information 

• Company/Organization Name: 

• Exact Address: 

 

2. Additional Insured Information 

• Name & Address: 

• Required Wording :

 

3. Event Details 

• Venue Name & Address: 

• Setup Date & Time:

 

You can copy this information, fill in the blanks, and send it to steve@stevesandoval.com. If you need any further assistance, please contact the insurance agency directly.

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