Certificate of Insurance Request

Please complete the following to obtain a certificate of insurance (COI) to submit to a third party vendor/sponsor.

  • (You may select more than one type of COI if required) Student Intern Liability Coverage FAQs
  • Certificate Holder (entity requesting the COI)

  • Outside Entity Name
  • Reason for COI
  • MM slash DD slash YYYY
  • MM slash DD slash YYYY
  • Requester Information