Certificate of Insurance

Sample Certificate of Insurance

A certificate of insurance (COI) is a document issued by an insurance company or broker. The certificate verifies the existence of an insurance policy and contains the name of the insurance company, policy number, name of the insured, types and limits of coverage, and the policy period.

 
Keep in mind that a COI is a snapshot of their coverage as of a moment in time. It is possible for the entity / person you are working with to cancel their policy after they have given you a COI. This is why contractually requiring the entity / person to carry insurance is always recommended. 
 
How to Request

If a member of the campus community is required to submit a certificate of insurance to a vendor, please email the following information to the Office of Risk Management at least 14 days prior to the date when the certificate is needed.

 

 

 

To submit a certificate request, you can click this link, or copy paste the information below:

  1. General:

    1. Has this certificate been requested before (Yes/No)? If so, PLEASE  attach a copy of the prior certificate.
    2. Will this certificate need to be renewed? (i.e., will you automatically need a copy next year, too?)

  2. Your Information:

    1. Your name
      •  
    2. Your department
      •  

  3. Outside entity requesting the certificate:

    1. Name of company/agency/organization
      •  
    2. Complete mailing address of company/agency/organization
      •  
    3. Phone number
      •  
    4. Name of specific person requesting the certificate
      •  
    5. Email of specific person requesting the certificate
      •  

  4. Event / Certificate Information:

    1. The who, what, why, and where of your activity (helpful to include numbers of people involved)
      •  
    2. What needs to be insured (specific activity, equipment, facility)
      •  
    3. Amount of insurance requested (frequently, there is specific language required by the vendor)
      •  

  5. Attachments:

    1. Attach any contract between UVU and the vendor that is requiring the certificate
    2. Remember to attach a copy of the prior Certificate of Insurance, if this has been requested before.