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Use of Donor Homes/Facilities for Fundraising

To obtain this insurance coverage:

  1. Sponsoring UCLA Department: Obtain an insurance quote from:
    1. Select: “Other constituencies”
    2.  “Additional Insured Name”: Donor’s name.
  2. Contact Insurance & Risk Management x46948 (Dean Malilay or Cynthia Roberts) if you have any questions regarding the application process.
  3.  Send the completed form to: Email:, Fax: (715) 344-6126
  4. Once the sponsoring UCLA department receives the quote, submit payment to Special Markets Insurance Consultants, Inc. 1055 Main St., Suite 101, Stevens Point, WI  54481. A department credit card (P-Card) or personal credit card (seek reimbursement through UCLA) can be used to make payment. The credit card authorization form is available here.
  5. If your department does not have a P-Card or a personal credit card to reimburse, contact Javier Fajardo in Purchasing to assign a buyer with a P-Card to assist you. 
  6. Please note that the insurer requires the following in order to activate the coverage:
    1. Signed application
    2. Payment (or proof of payment) sent with the returned application. Payment needs to be made prior to the effective date of the policy.