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Get UCSB Request for Proof of Insurance From Contractor or Vendor 2003-2021

Ificate of Insurance from a contractor, vendor, or consultant with whom the University is doing business and from whom it is necessary to obtain proof that he or she carries insurance. DEPARTMENT Date of Request: _____________ Campus: SANTA BARBARA Dept. Acct. No: ______________________________________________ UCSB Agreement/P.O. No: ________________________________ Effective Date: _________________ Expiration Date: _______________ Department: ______________________________________________ .

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