All Guilds which pay their SCCQG Membership and Insurance Premium are listed in the "Name of Guild" box below and may request a certificate of insurance. Fill out this online form and send the check separately to the address listed below. It can take 2 or 3 weeks.. so be sure to do this a month or so before your event.
Send a check TODAY for the above selected certificate amount (plus RUSH fee if necessary) payable to "SCCQG" to the SCCQG Treasurer at:
Don Beld
2417 Riverside Place
Los Angeles, Ca 90039-4010
It is NOT NECESSARY to include a copy of this online form with your check ;) Just your Guild name.. and a short note letting the treasurer know what certificate you are paying for.
Late payment will jeopordize your Guild's use of this online order form.
The SCCQG Insurance Coordinator is: Pam Overton
You may email Pam with questions at: pam.overton@ngc.com
Date(s) of event:
Owner of facility
Legal Name:
Contact:
Mailing address:
Name and Address of facility:
(if different from "Legal Name & Address" above):
Please allow 2 to 3 weeks
processing time, OR
RUSH If your event is less than 30 days away
Facility FAX #
for Rush orders only.
NOTES:
Your copy of the certificate will be emailed back to you. The original will be sent from the insurance company to the Owner of the Facility listed below.
Include your set up dates
Type of event
No Rush means: process this certificate in 2 to 3 weeks and mail it to the Legal Owner of the facility
RUSH means: process this certificate and FAX it to the facility at the number below:
Insurance Summary document available to ALL guilds who pay their insurance premium. NO COST
