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Council Facility Certificate of Insurance Request Form

  1. Only one COI request per form. Do not combine multiple COI requests into one submission. You will be asked to resubmit them separately.

  2. Request Deadline

    You must submit this request at least 10 or more business days PRIOR to the reservation date. For rush requests, please complete this form AND contact Linda Cooper at 301-600-1177 or Lauren Vandergrift at 301-600-1357.

  3. Does the Certificate Holder request to be an Additional Insured? *
  4. Will this certificate be needed every year or is this a one-time event? *
  5. Where COI will be emailed. You may have up to 3 emails. Please separate the emails with a comma.

  6. Attach either a Rental Agreement or Rental Application. Failure to provide it with the initial request will only delay the process

  7. Leave This Blank:

  8. This field is not part of the form submission.