Alumni & Friends of Principia:
Principia Clubs
Principia Club Insurance Request Form
Principia Clubs: Insurance Request Form
Liability Insurance Information

If the hotel, hall or other establishment requires an Insurance Certificate, please return to the Field Activities office the form below. If the management of the rental facility to be used requires that a contract be signed, please submit that contract to the Field Activities office for review by legal counsel before it is signed by the club President.

All activities sponsored by clubs are automatically covered by Principia’s Comprehensive General Liability policy. The coverage includes:

  • General Liability
  • Bodily Injury & Property Damage
  • $1,000,000.00 coverage ($100,000.00 deductible)
Insurance Certificate Request Form

(Please use this form when requesting proof of insurance for renting or using buildings for events. Keep a copy.)

Please select your Principia Club:

Date of Event:

Time of Event: (Includes set-up and clean-up)

Place of event: (Address and phone)

Contact at location of event: (Name and phone)

Type of event (purpose):
(Speaker Event, Christmas Sing, etc.)

Principia Club contact: (Name and phone)

Who do you want to receive the original certificate? (Name and address)

Who do you want to receive copies of the certificate? (Name and address)

Submitted by
Email