Request a Certificate of Insurance

How to Request Your Certificate of Insurance

A certificate of insurance is a document that is used to provide information about the status of a business’ insurance policies. These documents include the various policy types, policy numbers, effective periods and coverage limits. Certificates of insurance of typically issued to the requesting party who is known as a certificate holder and are listed on the bottom left of the certificate.

In the description section of the certificate is a space that will list specifics about the request along with any additional insureds or additional insurance language as required.  

The request a certificate link below is designed to be an easy and efficient way for you to request and receive your certificate of insurance in a timely manner.

Need Something Else?

Have a different request? Check out our Resources section to download other useful forms or submit information to DurAmerica directly through this website.

DurAmerica Certificate of Insurance Request Form
** CERTIFICATE REQUIRES ADDITIONAL INSURED TO HAVE A VALID WRITTEN CONTRACT IN PLACE AS DEFINED IN THE POLICY **

Add Additional Insureds

Person or organization that enjoys the benefits of being insured under an insurance policy. List up to 6 insured people/companies

If you require more than 6 additional insureds, please use the basic method at the beginning of this form.

Please provide the insurable interest of EACH entity

Additional #1
Additional #2
Additional #3
Additional #4
Additional #5
Additional #6

That's it! You're ready to submit!

DurAmerica Standard Quote Form

Products of Interest

Individual Information

Company Information

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