Request a certificate of insurance.

Tell us who the certificate should name and what your contract requires. We pass it to our broker and send the certificate to the address you give.

About you

Full nameCompanyEmailPhone

Certificate holder

The organization the certificate should name, exactly as it appears in your contract.

Legal nameStreet addressAddress line 2 (optional)

CityState or provincePostal code

Country

Additional insured

Does the contract require the holder to be named as an additional insured?

Yes No

Coverage and minimum limits

Tick each coverage the contract requires and enter the minimum limit it states.

Other coverage (optional)

Endorsements

Waiver of subrogation required?

Yes No

Primary and non-contributory required?

Yes No

Contract and delivery

Project or contract reference (optional)Needed by

Send the certificate to

Insurance clause

Attach the contract's insurance requirements as a PDF (4 MB max), or paste the clause below.

PDF (optional)Clause text (optional)Notes (optional)

Your request goes to Soapbox by email. We use it only to arrange the certificate.