Add Driver to GHARRP Insurance

Add Driver to GHARRP Insurance
Member Housing Authority
The {memberHousing} Housing Authority has approved the driver below and authorized him/her to be added as an authorized driver to be covered under the {memberHousing} Housing Authority insurance coverage through GHARRP.
Driver

First NameLast Name
Driver's License Number
State of Issuance
Expiration Date

MonthDayYear
Date
The Driver's relationship to the Authority is:

EmployeeVolunteerContracted EmployeeOther Authorized Driver (explain)
Certification

Attached is a copy of the above Driver's valid driver's license.The above Driver is authorized by the Authority to drive an Authority vehicle covered by GHARRPThe Authority acknowledges it is the Authority's responsibility to approve a driver and authorize their coverage under GHARRP. GHARRP accepts that approval and authorization once submitted to us in writing for coverage under the GHARRP policyOther
Type a question
The {memberHousing} Housing Authority submits {driver} (valid driver's license attached) as an approved and authorized driver. If this is a volunteer driver, the Authority acknowledges that the driver and the Authority meet GHARRP's 'Volunteer Drivers" requirements.

Further, the {memberHousing} Housing Authority acknowledges that it should always exercise dilligence in approving qualified, competent, well-trained drivers to be covered under the Authority's insurance with GHARRP.
Submitted by:

First NameLast Name
Reporting Party E-Mail
example@example.com
Title
Date

MonthDayYear
Date
Attach copy of Driver's License here:

Cancelof
Signature

Clear
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