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INSURANCE FORMS

Initial Injury Report
(this form must be completed for any injury occurring at a CDPW event)
2010 Request Insurance Certificate
(complete this form to request a Certificate of Insurance, form may be mailed to the
CDPW Insurance Coordinator at the PO Box 212, Delmar, NY 12054)
Insurance Claim Form and Instructions
Claim Form
(Please complete this form as described on the included instructions.)
PROPERTY FORM 2010