Certificate of Insurance Request

Frequently your site will be asked to provide companies or other agencies with evidence of your Member's insurance coverage, typically referred to as a “Certificate of Insurance.” NBSIA arranges for the certificates to be issued.

These certificates by themselves provide information only to the requesting party, including the types of coverage held, name of the insurer, expiration dates and limits. There should also be a description of the event being covered, and any other pertinent information.

Should a request be made for an “additional insured endorsement,” a separate page is included with the certificate. This page endorses the requesting party onto the Member’s policy, and should any loss occur as a result of the relationship between this party and the Member, NBSIA will be called in to cover that loss. Obviously, this endorsement is not one that should be taken lightly, and a close review of the Member’s agreement with the other party should be undertaken before the endorsement is issued.

PLEASE NOTE : Certificates are not issued directly out of the NBSIA office and can take up to five working days to produce. Please allow enough time when making a request.

WARNING: Rental interruption protection is frequently one of the coverages required in a lease agreement or certificate of participation. This coverage is not automatic and requires specific endorsement of the leased property onto our policy. If your contract requires this coverage, please make this clear to NBSIA.

Procedures for Requesting a Certificate and/or Endorsement:

  1. Fax or email a copy of the contract/agreement between the Member and the vendor to NBSIA.
  2. If the agreement does not specify the below information, please add it on a separate sheet.
  3. Upon receipt of a certificate request, we will review the agreement and begin processing the certificate.

Please make sure you provide the following information to NBSIA:

For Special Events (see Special Events Coverage for more information and request form):

  • Who: Name and address of vendor or venue requesting the certificate
  • When: Date and time of event
  • Why: Description of event or activity
  • What: Description of participants
  • Where: Location

For Property (i.e., portables, photocopiers, vehicles):*

  • Make, model, and year
  • Description (size)
  • Lease or loan number
  • Value of equipment
  • Serial number
  • Loss payee if applicable
  • Location of equipment

For buses: # of passengers

  • Indicate any special circumstances or requests.
  • Provide the name of an individual at the Member who can answer questions we may have.


Use the links below to view sample certificates: