Request a Certificate of Insurance

The University often needs to provide a Certificate of Insurance to third parties to verify its insurance coverage. All requests must be submitted to Risk Management, which will review the request and, if necessary, notify the University's insurance broker to issue the certificate.

Please submit your certificate requests as early as possible. Do not wait until the due date, as it can take up to 48 business hours to be processed.

The following information is needed to complete the Certificate of Insurance Request Form:


Form Section Instructions
Requestor Information Enter your contact informaiton as the requestor of the Certifiate of Insurance.
Certificate Holder Information

Enter contact information for the third-party Certificate Holder:
 - Name of organization or entity
 - Contact name and email address
 - Mailing address
Request Details

Description of Activity
 - For events, activities, and performance contracts, include the location of the event or activity.
 - For leased and rented property, (i.e., computer equipment), include a description and the dollar value of the property.

Request Type
 - This includes events, activities, research programs, leased and rented property, and various contracts.

Request Duration
 - One-time (COI covers an activity that has a beginning and end date
 - Ongoing (COI should be renewed annually)

Activity Date(s)
 - Enter the Start Date and, if applicable, End Date for the activity.

COI Distribution
 - The COI can be emailed to the organization and/or University requestor.

Additional Insured Status
 - If the organization requests to be an Additional Insured, you must upload a copy of the contract. Additional Insured status cannot be provided without a copy of the contract requesting such.

Comments to Risk Management
 - Add any additional comments you feel would be helpful or any special requests.

If you have any questions, please contact Yahneet Govine.