Certificate of Insurance Request Form

Need proof of insurance/a certificate of insurance(COI)?

Getting a certificate of insurance is easy for ALIGNED Insurance clients! Simply complete and submit the below request form and our team will take care of it or email certificates@alignedinsurance.com with any questions.

Your Email Address*

We need this to validate your file and communicate with you regarding your certificate of insurance request.
Your Company Name*
i.e. The Named Insured listed on your insurance policy.
Your ALIGNED Insurance Client Code (if known)
Your client code is on every ALIGNED Invoice and should be in numerous subject lines of emails you received from your Advocate or documents@alignedinsurance.com
Certificate Holder Name*
The full legal name of the third party entity requesting the certificate of insurance. i.e. The organization asking you for evidence of insurance
Certificate Holder Address*
The full mailing address of the third party company or organization that is requesting you to provide a certificate of insurance
Policy Type(s)*
Please list all policies that have been requested to be evidenced on the certificate of insurance. i.e. CGL, Property, E&O, Cyber etc.
Limit Requested*
The $ amount of insurance requesting to be evidenced on the certificate of insurance by policy type. ex. $1M CGL
Additional Details
Additional insured requested?*
Has the certificate holder requested to be added as an additional insured to your policy?
- Yes
- No
Would you like the certificate sent directly to the certificate holder?
- Yes
- No
Please provide a valid email for the certificate holder
Submit Supporting Documents
If applicable, please attach the certificate request form or the insurance requirements section of the contract, lease, RFP or agreement that outlines the amounts, types and details of the insurance required to be shown on the certificate of insurance being requested.
Drop files here or

Max. file size: 5 MB, Max. files: 4.
Do you have any additional instructions, deadlines, details etc. you think we need to know about this certificate of insurance request?
Any additional details, info, instructions, special coverages, extensions, Event Name, Event Location, Event Date(s), job/project name, etc.?

Certificate of Insurance Request Form

Need proof of insurance/a certificate of insurance(COI)?

Additional Details