Request Certificate of Insurance

A Certificate of Insurance is a document issued by an insurance company that is used to verify the existence of insurance coverage under specific conditions granted to listed individuals.

Please click on the link below and complete the form to request a Workers Compensation certificate of insurance:

This form is required in order for us to be able to process each request quickly and correctly.  If you have any questions, please call our office at 800-462-6435 or email

Thank you.