General Liability Certificate of Insurance Request Form

Please fill out all of the following fields.
A copy of the submitted form will be sent to the Swim Club Contact email provided.
If any fields do not apply, please enter "N/A" for that field.
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What year are you requesting this certificate for? *
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Swim Club Information
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Swim Club Contact Information
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Certificate Holder Information
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Type of Certificate Requested: *
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                                                     This COI request form will be automtically sent to:
                                                         IOA Insurance Services
                                                         Attn. USAS Service Team
                                                         E-mail: USASCOI@ioausa.com
                                                         Phone: Paige Montgomery (303) 565-1126