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Certificate of Liability Insurance Request Form
Certificate of Liability Insurance Request Form
Today's Date
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Organization Name
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Organization Address
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Organization Phone Number
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Point of Contact for Organization
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Point of Contact Email
*
Special Notes to be Included on the Certificate (rare)
Reason for Request
*
(i.e. Overnight, Service Unit Event, Cookie Booth)
Name of New Mexico Trails Member Requesting Certificate
*
Email Address of New Mexico Trails Member Requesting Certificate
*
Service Unit
*
Troop Number
*