(only if you will be volunteering to transport students for school activities)
The above-named school requires proof of insurance in force on all private vehicles, prior to and during their use for the transportation of school sponsored trips on all in-county and out of-county trips. The groups being transported include, but are not limited to, students, parents, teachers, staff and volunteers. In addition, each driver must be in possession of a current valid driver’s license.
This form is to be completed for each private vehicle used and is valid for the school year in which it is filed. If the insurance policy expires or is cancelled during the school year, a new statement must be submitted.
This is to certify that insurance policies, subject to their terms, conditions and exclusions, are at present in force with the company indicated.
This also certifies that the same provides for personal injury protection in a sum of not less than $10,000.
I certify that the above information is correct.
