Certificate of Insurance

Purpose

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 (among other information). It identifies what insurance will cover for the named insured, and what financial protection might be available in the event of a loss. It gives no rights to the entity for whom the certificate is being requested in regard to the actual insurance policy. Neither can it alter or modify coverage(s) on the actual policy.
 
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. 
 
We will attempt to comply with reasonable requests made by outside entities, but it may not be possible in some cases to comply with their requests. The Utah Division of Risk Management and WCF are responsible for approving the certificates at their discretion.  Certificates will not be approved for insurance types not provided by the Utah Division of Risk Management or WCF.  Total coverage and coverage amounts may be limited by exclusions and the Utah Governmental Immunity Act. 

How to Request

**Has your contract been reviewed by Contract Services? Per Policy 247 (see 5.3.1), we CANNOT provide a Certificate of Insurance unless the contract has been reviewed and approved by Contract Services. Please contact [email protected] or visit https://my.uvu.edu/workplace/procurement/contracts/index.html for more information.

To submit a certificate request, you can click this link, or copy paste the information below. Please submit this information at least 7 days prior to when the certificate is needed. 

  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.