If you are interested in Merchanting at War Practice, please provide the following information.
Coopers Lake's insurance company requires all merchants to provide proof of current insurance:
| Business Name: |
_______________________________________________________ |
| Owner's Name: |
_______________________________________________________ |
| Tax ID Number |
_______________________________________________________ |
| Business Address: |
_______________________________________________________ |
| |
_______________________________________________________ |
| Business Phone Number: |
_______________________________________________________ |
| Email Address: |
_______________________________________________________ |
| Website if applicable : |
_______________________________________________________ |
Copy of
Certificate
of Insurance: |
You must provide a copy of your liability insurance. |
|
Thank you and we look forward to seeing you at War Practice
THLady Alessandra d'Avignon
Merchant Liaison
176 S. McCoy Place Road
Sewickley, PA 15143
412-741-8537
kardasl (at) pitt.edu |
