Iowa Knights of Columbus Certificate of Insurance Request Form
Use this form to order a Certificate of Insurance
** TO BE COMPLETED BY K OF C MEMBERS ONLY **

Every diocese in Iowa requires K of C Councils to carry liability insurance in order to use parish facilities for any activity.

The State Council provides coverage that applies to every council unless a council has its own active and adequate liability policy. The policy period for coverage provided by the State Council is from July 1 - June 30 annually. Councils are assessed an annual premium of $1 per member in the July State Per Capita billing.

All dioceses and parishes are additional insured. 

Liquor Liability is not covered. For council events or activities providing or selling alcohol a separate event policy with Liquor Liability will be required

A certificate with no Certificate Holder named is available HERE

Use this form to request a Certificate of Insurance with specific Certificate Holder(s). 
** TO BE COMPLETED BY K OF C MEMBERS ONLY **
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Name of the member making the request: *
Email address of the member making the request: *
Council # *
Certificate Holder(s) Information:
*Enter information for each Certificate Holder needed.
Example:
St. Mary's Catholic Church and the Diocese of Davenport
123 Main St
Anytown, IA 50000

Please include the entire mailing address
 *
List others (names and email addresses) who need copies of the certificate
If more than one certificate is requested please indicate who should receive the appropriate certificate.
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