Certificate of Insurance Request Certificate of Insurance Request request for insurance certificate Full Name* Dr.MissMr.Mrs.Ms.Prof.Rev. Prefix First Last Suffix Email* Phone: Type of Event:*please choose oneUnitDisrtictCouncilAreaUnit #: Unit Type (Troop, Crew, Team, Post): Dates Needed:* Please provide a brief description of the activity:*If certificate is for use of facilities, describe:$1 Million Coverage* Yes No If the amount exceeds this, please contact Audrone at the Council Service Center, 520-750-0385.Certificate Holder Name:* Certificate Holder Address:* Additional Comments: