Cal South Field Insurance Request

Cal South Certificate of Insurance (COI | Ecert) Request

Please complete the form and payment below to initiate your field certificate request. Individual filling out this form must be on the club board of directors.
Acknowledgment: Only Cal South affiliates with current registered players can request field insurance certificates.*
Your Full Name

First NameLast Name
E-mail
Phone Number

Area CodePhone Number
Club Name
Club ID
Your Title/Role for your club.
(President, Registrar,..)
Date you need by:
Certificate Holder Name & Address
Enter the name/address of the entity that needs evidence of insurance, i.e. the school district, city municipality, etc.
Description and/or Location of Event:
(The actual field, school or park name)
Acknowledgement: Liability coverage is only for Cal South sanctioned events and activities through expressed written approval from Cal South. Distinct and separate sanctioning is required for tournament, Fall and Spring league hosting. Team practice and game fields are covered during the annual renewal process and when a certificate is requested, approve and issued. We reserve the right to remove coverage for any violation of Cal South rules, regulations and policies. Exclusions:We will not cover insurance for events such as fundraisers or any other non-soccer play related events or group gatherings.*
Types of Certificates Offered:
Standard Certificate

- Most commonly requested certificate

- Includes evidence of General Liability, Excess, Abuse & Molestation insurance coverages

- Automatically attaches Additional Insured Endorsement ECG 20 600
Special Certificate

(May only request Special if you include a copy of the contract and/or insurance requirements from the cert holder)

- Processing time may take longer

- Our team will read the contract and/or insurance requirements to determine if special

- Choose this option if the cert requestor is looking for special endorsements, like Additional

Insured CG 20 26, or special insurance coverages, like Auto Liability or Sport Accident Insurance.
Check which type of certificate you are requesting:
Additional Information or Special Verbiage Requested on Certificate (subject to approval):
Payment Portion

My Products

E-Cert Fee$103.50

Field insurance certificate fee per field. Fee includes Transaction Fee.

Quantity

Total $0.00

Payment Methods

Credit Card

Apple Pay

Google Pay

Cash App Pay

Thank you in advance. When you click the Submit button above we will recieve your request and start working on the order.

If you have any questions please contact us at administrativeservices@calsouth.com or 714-778-2972
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Cal South Certificate of Insurance (COI | Ecert) Request

Payment Portion

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