Certificate of Insurance Coverage/Hold Harmless Agreement/Workers Comp/W-9

To comply with diocesan procedures, St. Maximilian Kolbe must obtain a Certificate of Insurance and a signed Hold Harmless Agreement from contractors prior to the commencement of work on parish property. See below.

The parish must obtain for the contractor and have on file the following:

1. A Certificate of Insurance with General Liability limits of $2,000,000 naming  The Roman Catholic Diocese of Rochester and its
Affiliated Parishes and Schools and the Most Reverend Salvatore R. Matano, Bishop of The Roman
Catholic Diocese of Rochester, as additional insured.

2. A signed Hold Harmless Agreement

3. Workers Comp Certificate

4. W-9

You can fax to (315) 524-2612

or  Mail to:

St. Maximilian Kolbe Catholic Church
5823 Walworth Road
Ontario, NY 14519

Any questions please call 315-524-2611  x 11 and ask for Michele

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