Wilkes University

Certificate of Insurance Form

Certificate of Insurance Request Form

Certificate of Insurance Request Form

Certificate of Insurance Request Form

Complete this form to request a Wilkes University Certificate of Liability (COI) insurance be generated for a third party individual or company. (COI’s will be returned to you within 1-3 business days.)

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  • Wilkes Contact Information

     

  • - -

  • Insurance Required


  • Certificate Holder Information


  • Additional Insured


  • Agreement/Lease/Event Date


  • Reason For Certificate

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