Certificate of Insurance Request Form for Commercial Clients

To submit this form, you can email it to Horst Insurance at insurance@horst.com, fax it to (123) 456-7890, or use our online submission form at www.horstinsurance.com/submit-coi. You can also mail it to Horst Insurance, 123 Insurance St., City, State, ZIP Code. It is advised to double-check all entered information and attach any required documents before submission.

No specific dates are required for this form in 2024 and 2025.

The purpose of the Certificate of Insurance Request Form is to streamline the process of requesting and providing proof of insurance coverage for commercial clients. This form helps ensure that all necessary information is accurately documented, which is essential for fulfilling contractual obligations, meeting project requirements, and verifying insurance coverage. By using this form, commercial clients and insurance agents can efficiently handle COI requests and avoid potential delays or issues related to insurance verification. Additionally, the form facilitates clear communication and understanding between all parties involved in insurance transactions, enhancing trust and reliability in business relationships.

• 1. Your Contact Name: Enter your first and last name.
• 2. Your Business Name: Provide the name of your business.
• 3. Your Address: Fill in your street address, city, state, and zip code.
• 4. Your Contact Phone #: Enter your contact phone number.
• 5. Your Email: Provide your email address.
• 6. Certificate Holder Name: Enter the name of the certificate recipient/holder.
• 7. Recipient Address: Fill in the recipient's street address, city, state, and zip code.
• 8. Policies to Reference: Choose the relevant policies to reference on the certificate.
• 9. Additional Insured Requirement: Indicate if the certificate holder requires being named as an additional insured.
• 10. Waiver of Subrogation Requirement: Specify if the certificate holder requires a waiver of subrogation.
• 11. Special Instructions: Enter any special instructions or attach the original COI request.

Failing to submit this form may result in delays or inability to provide proof of insurance.

• Delayed Processing: Not submitting the form on time can cause delays in processing the Certificate of Insurance.
• Contractual Issues: Failure to provide a COI may affect contractual agreements or project requirements.
• Insurance Verification Problems: Without the form, verifying insurance coverage for various parties could be problematic.

• 1. Contract Requirements: Use this form to comply with contract stipulations requiring proof of insurance.
• 2. Project Verification: Submit this form to verify insurance coverage for a specific project.
• 3. Business Agreements: Utilize this form to fulfill business agreements needing insurance proof.
• 4. Client Requests: Respond to client requests for insurance verification using this form.
• 5. Insurance Renewals: Provide updated proof of insurance during renewal periods with this form.