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National Insurance Policy Proof of Insurance Certificate

1. If a Land/Facility Owner requests a “Proof of Insurance” for a Branch Event, fill out the form below and submit.

2. If the Land/Facility Owner requires to be added as an “Additional Insured”, check the “Additional Insured Certificate” box below, complete the form and submit

These certificates will be sent directly to the land/facility owner(s) requesting the coverage.

Please submit both of these requests not less than 20 business days prior to the date the certificate is needed by the landowner. The insurance agent needs time to process these requests. Requests made at the last minute may not be able to be processed by the time you need it!   ( See Question 15 on the Insurance FAQ page )
Always check with the person requesting the Certificate to make sure ALL information is correct before submitting the request.  If the insurance company is required to process changes to a certificate for an event because of incorrect information, there may be a charge to the branch.
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Beginning Date and Time of Event
Ending Date and Time of Event
Do you need an "Additional Insured Certificate"? (Note: if you choose yes, the land/facility owner automatically gets both certificates.)
Do you need a "Proof of Insurance Certificate"?
Contact Address
Address of Venue
Land/Facility Owner Address


If you have any questions regarding our insurance, such as information on Insurance coverage, and requests, information on insurance non-coverage related questions, such as form submittal problems, or if you have problems resolving a problems with our insurance agent, contact:

Jeff Fenske
1331 10th Ave,
Kingsburg CA 93631
(559) 907-9734
[email protected]

This page was last modified: December 6th, 2023

All membership dues and lists are to be sent to the Secretary/Treasurer. Click on the Administration Page to find contact information for the officers.

All correspondence should be directed to the President, any questions should be sent to the Regional Director and all insurance questions to be sent to the Director handling insurance.

All EDGE&TA Membership Correspondence Should be Directed To: Michele McGill – EDGE&TA Secretary[email protected] | , .

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