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Ecology Publications & Forms |
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Ecology Publications & Forms |
| Title | Certificate of Insurance Form |
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| VIEW NOW |
Certificate of Insurance Form (Number of pages: 4) (Publication Size: 341KB)
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| Description | Certificate of Financial Responsibility applicants may use this form to document the details of their insurance coverage. It should be signed by a representative of the insurance company and documents their agreement to provide insurance proceeds for covered events. | ||||
| REQUEST A COPY |
The mission of the Department of Ecology is to protect, preserve, and enhance Washington’s environment. To help us meet that goal, please consider the environment before you print or request a copy.
ADA Accessibility The Department of Ecology is committed to providing people with disabilities access to information and services by meeting or exceeding the requirements of the Americans with Disabilities Act (ADA), Section 504 and 508 of the Rehabilitation Act, and Washington State Policy #188. Visit Ecology’s website for more information |
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| Contact | Diana Davis at 425-758-0483 or Diana.Davis@ecy.wa.gov | ||||
| Keywords | insurance, COFR, Certificate of Financial Responsibility | ||||
| RELATED PUBLICATIONS |
Title:
Proof of Financial Responsibility - Instructions Attestation Form Surety Bond Form Chief Financial Officer Letter Agreement Form |
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