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.

 
 
 
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. Your Information:

    1. Your name
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    2. Your department
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  3. Outside entity requesting the certificate:

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

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