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CRMA - California Risk Management Authority

Certificate of Insurance Request Form

7170 N. Financial Drive, Suite#130
Fresno, CA. 93720

Attn: Lisa Perez

Request for Certificate of Insurance Checklist

Request for Certificate of Insurance Checklist iconRequest for Certificate of Insurance Checklisttitle

  1. Name, mailing address, contact name of certificate holder (party requesting proof of insurance
  2. Copy of contract/agreement stating insurance requirements from certificate holder
  3. (If this information is not on contract/agreement please request a copy in writing)
    Date of event
  4. Description of event (include organization/school participating in event)
  5. A two-week advance notice would be appreciated to process the paperwork.
No Certificate of Insurance and/or Additional Insured Endorsement will be issued until all the above information is received in our office.