Certificate of Insurance | Michigan Catholic Conference

Whether you need a COI for an event, equipment lease or rental, or use of third party space, please fill out the request form in its entirety and we will provide you with the certificate or contact you with questions.

Required fields are marked with a *

Parish Info

Parish Name* Unit No.* Address* City* Zip* Phone*

Contact Info

Your Name* Email*

Certificate Holder Info

Who is requesting to see coverage?

Certificate Holder Name* Address* City* State* Zip*

Description of Operations

Type of COI Requested*

Property Leased equipment (copiers, printers, lifts, etc.) Liability Use of facilities, sports, parish picnic/retreat, contracts, etc.

Coverage Start Date* Coverage End Date

What is the use for the equipment/facilities? Please include contract, agreement, and account numbers if applicable.