About this template
An Insurance Certificate Request Form is essential for insurance agencies, brokers, and risk management teams looking to streamline how clients or contractors request Certificates of Insurance (COIs). Processing these requests manually often leads to missing details, delayed project start dates, and endless back-and-forth emails.
This comprehensive Google Form template collects everything needed to issue an accurate COI in record time. It captures vital policyholder details, policy numbers, specific certificate holder requirements, additional insured specifications, project locations, and detailed job descriptions. By centralizing this intake process, your team can eliminate ambiguity, reduce processing times, and issue certificates safely and efficiently.
Whether you are managing commercial liability requests for construction projects, vendor agreements, or real estate leases, this template ensures you get all necessary information on the very first submission. With Doc2Form, you can instantly turn this template into a ready-to-use Google Form and start collecting organized requests immediately.
Key features
- Collect policy numbers and policyholder details in one structured submission.
- Capture exact certificate holder names, addresses, and delivery emails.
- Gather specific project locations, job types, and construction details.
- Include fields for additional insured status and contractual obligations.
- Provide a secure file upload link for supporting documents and contracts.
Use cases
General contractors requesting COIs from subcontractors before starti…
General contractors requesting COIs from subcontractors before starting a job.
Commercial tenants submitting insurance verification to property mana…
Commercial tenants submitting insurance verification to property managers.
Insurance agencies receiving daily certificate requests from business…
Insurance agencies receiving daily certificate requests from business clients.
Event organizers gathering proof of liability insurance from vendors.
What this form collects
- Request ID (Short answer)Enter your internal tracking number or leave blank if not applicable.
- Policy Holder's Name (Short answer)Enter the legal name of the insured business or individual.
- DBA Name (Short answer)If applicable, enter the 'Doing Business As' name.
- Policy Number (Short answer)Provide the active insurance policy number associated with this request.
- Requested By (Short answer)Enter the full name of the person submitting this request.
- Email Address (Short answer)We will send the completed certificate to this email address.
- Phone Number (Short answer)Enter a direct contact number in case we need clarification.
- Certificate Holder Name (Short answer)Enter the exact name of the entity to be listed as the certificate holder.
- Certificate Holder Address (Paragraph)Provide the complete mailing address for the certificate holder.
- Additional Insured Status (Multiple choice)Does the certificate holder require Additional Insured status?
- Additional Insured Name(s) (Paragraph)If yes, list all names to be included as additional insured parties.
- Job / Project Location (Paragraph)Provide the street address or location where work will be performed.
- Project Type (Dropdown)Select the category that best describes the project.
- Detailed Job Description (Paragraph)Describe the specific operations, services, or work being performed for this request.
- New Construction Involvement (Multiple choice)Does this project involve new construction?
- Comments or Special Instructions (Paragraph)Include any additional wording requirements, waiver of subrogation notes, or special requests.
- Supporting Document Upload (Paragraph)Please paste a link to your file (Google Drive, Dropbox, etc.) or describe the document you wish to attach.
FAQ
What is an Insurance Certificate Request Form?
It is a structured intake form used by policyholders, contractors, or vendors to request a Certificate of Insurance (COI) from their insurance provider or broker, detailing specific project requirements and certificate holder information.
How does Doc2Form help me use this template?
Doc2Form instantly converts this template into a fully functioning Google Form, allowing you to start collecting certificate requests in seconds without manual rebuilding.
Can I customize the questions on this form?
Yes! Once the template is in your Google Forms account, you can freely add, remove, or edit any questions to match your agency's specific underwriting or policy requirements.
How are supporting documents like contracts handled?
The template includes a dedicated file upload field where respondents can paste a link to their supporting documents, project agreements, or previous certificates.
Who typically fills out this form?
Subcontractors, business owners, event vendors, and commercial tenants usually fill out this form when they need proof of insurance issued to a third-party certificate holder.
Get this form in your Google Drive
Save a copy to your Google Drive with one click (uses 1 credit). Or build from a PDF or description in the app.