UNIVERSITY OF WISCONSIN River Falls

Certificate of Insurance/Coverage Application
   
   
   
   
Example: 01/01/2013 - 01/05/2013

Enter Name of Organization Here.

What organization is this being issued to?

Where can the Certificate of Coverage be mailed to?

Where can the certificate of coverage be emailed to?

Where can you be reached at, if we have questions?

Why do you need the certificate of coverage?

 
 

Contact Us

Risk Management
Email: Connie Smith, MS
Phone: 715-425-3344
Fax: 715-425-4980
25H North Hall

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