Request a Certificate of Liability Insurance

Policy Holder Information

Named Insured (required)

Contact Name (required)

Contact Telephone (required)

Contact Email (required)

Preferred Method of Contact

TelephoneEmailNo Preference

ID #, Client #, or Memorandum # (required)

Certificate/Additional Insured Information

Name (e.g., venue, facility, school district) (required)

Address (required)

Address Line 2

City (required)

State (required)

Zip Code (required)

Event Information

Event Description (required)

Event Start Date (required)

Event End Date (required)

Optional Additional Insured Wording

Optional Additional Insured Endorsements
Does your additional insured require a primary/noncontributory endorsement or a waiver of subrogation? YesNo

Primary/NoncontributoryWaiver of Subrogation
If an additional cost applies, you will be contacted by our office.

Email Certificate

To Email a Certificate to the event location or another email, please enter email address.

Need Assistance?

Office Hours
Monday through Friday
8:30AM to 5:00PM Pacific Time
Toll Free: 800.364.2433
Telephone: 818.980.1413
Fax: 818.980.1595
Email: support@rvnuccio.com


Certificate Explained

acord-website

Need help understanding your Certificate?
View RVNA's Certificate of Liability Explained.