Compliance & Risk Management > Risk Management > Certificate of Insurance Request Form

Certificate of Insurance Request Form

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Your Information

 Certificate Holder

Select a date from the calendar.

Event Details


Select a date from the calendar.

Certificate Information


NOTE: Please send a copy of the agreement or contract prior to signing.


NOTE: Risk Management requires a copy of the written contract or agreement if the certificate holder (requestor) is requesting to be named as "additional insured," "loss payee" and/or "mortgagee."


If you have any questions please contact us at insurancecertificate@depaul.edu.

Before clicking the Submit button, please take time to review the accuracy of your COI Request.

Thank you,
The Risk Management Team​​​​​​​​​​​​