Request for liability insurance - Mt Diablo Silverado Council 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by filling in your Pack/Troop/Team/Crew/Post/Ship number and District in the designated fields.
3. Enter your name, address, city, and zip code accurately to ensure proper identification.
4. Provide your contact numbers, including home, work, fax, and cell phone numbers.
5. Indicate the amount of liability insurance you are requesting by checking either $1 Million or specifying another amount.
6. Fill in the name and address of the property owner (Certificate Holder) where applicable.
7. If different from the Certificate Holder's address, provide the address of the property you will be using.
8. Clearly state the purpose of usage and the dates for which you require insurance coverage.
9. If applicable, indicate whether you are paying a fee for using the property and specify the amount along with any discount details.
10. Select if this is a service project or an Eagle project and add any additional helpful information as needed.
11. Choose how you would like to receive your certificate: mailed or faxed to you or the property owner.

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