Certificate of Insurance Request Form

Certificates of Insurance (“COI”)

A Certificate of Insurance (COI) is a form that identifies how much insurance coverage the holder possesses.

Why is a COI needed? Girl Scouts of Eastern Pennsylvania (GSEP) is obligated to ensure, to the extent reasonably possible, that any external entities, such as vendors, program providers/collaborators, organizations, companies, sites or facilities used are safe. One measure of safety is evidence of adequate insurance coverage. When planning events on behalf of GSEP (for example, meetings with girls, day camps, service unit events, activities with vendors, etc.), certificates of insurance (“COI”) are needed to verify that an organization or location meets Girl Scouts’ insurance standards. Likewise, facilities and vendors often request a COI from Girl Scouts of Eastern PA.

Requester First Name

Requester Last Name

Requester E-mail

Service Unit or Troop Number

SU/Troop E-mail

Name of Facility

Address of Facility

Contact Name at Facility

Facility Contact E-mail

Facility Contact Fax Number

CLICK HERE to submit a COI from an external Organization

Determine if your event/activity requires a COI
Check if we already have a COI on file for the Organization: View the list of organizations with a current COI on file with Girl Scouts. If we do have a COI on file, an additional copy is not required. If the Organization you are looking for is not listed, continue with the steps below.
Contact the Organization and request a COI.
The certificate should have the following characteristics:
1. General liability per occurrence minimum of $1,000,000
2. TRANSPORTATION COMPANIES SHOULD PROVIDE EVIDENCE OF AUTOMOBILE LIABILITY IN AN AMOUNT NOT LESS THAN $1,000,000.
3. Scheduled events fall within policy period shown on the certificate,
4. The Certificate Holder box (bottom left corner) must contain:

Girl Scouts of Eastern Pennsylvania
330 Manor Road,
Miquon, PA 19444

Submit COI Document

CLICK HERE to Request GSEP send our COI to a vendor

If an Organization requests a COI from GSEP, you may provide our evidence-only certificate.
If the Organization requires more information than what is on the evidence-only certificate, check if we already have sent a COI to a business/organization.
If the Organization you are looking for is not listed, complete and submit a Certificate of Insurance Request Form four weeks prior to the event/activity for which it is needed. All parts of the form will need to be completed in order to fulfill the request.

Requests may take 7-10 business days to process, especially in high volume seasons. Our team will process you request and send a copy of our COI directly to the vendor.

Select the purpose of the proof of insurance

One-time meeting, activity, or trip

Ongoing troop/service unit meeting place or activity

Activity Name

Activity Date(s)

Our insurance certificates are renewed on July 1st each year. Please indicate here if a renewed certificate should be sent automatically to the certificate holder.

Yes

Did facility ask to be named Additionally Insured?

Yes

Additional Insureds (if required by facility)

Comments or special wording/instructions

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