3. To request a Certificate of Insurance, please contact Cynthia Eghbalnia either by email or by phone (608-246-6291). The following information is necessary to process a request for a Certificate:

• Certificate Holder’s Name
• Certificate Holder’s Address
• Certificate Holder’s Fax Number
• Certificate Holder’s Contact Person (name, phone number and email address)
• Purpose for the Certificate (if an event, provide date and sponsor)