7/21/2011

Business Travel Accident Insurance

Sample Request for a Certificate of Insurance

To be placed on company letterhead and similar wording used within the contract

[Date]

[Company Name]

[Address]

RE: Current Certificates of Insurance

Dear [Name]:

It is our company’s policy to work only with companies who are properly insured. Please provide the following certificates for the line indicated:

Subcontractor – Provide Certificate of Insurance and maintain insurance for general liability with minimum limits of [$1,000,000 occurrence / $2,000,000 aggregate suggested], motor vehicle liability [$1,000,000 suggested], and workers compensation, including employers liability. [Your company name] must be named as an additional insured on the Certificate of Insurance for general liability, and if possible, auto liability.

Fabricator – Provide Certificate of Insurance for general liability with minimum limits of [$1,000,000/$2,000,000 suggested]. [Your company name] must be named as an additional insured on the Certificate of Insurance.

Supplier/Vendor – Provide Certificate of Insurance for general liability coverage with minimum limits of [$1,000,000 suggested].

Design Professional – Provide Certificate of Insurance for general liability and professional liability coverage with minimum limits of [$1,000,000 suggested].

All Certificates of Insurance must be provided directly from your insurance agent, or insurance company.

Thank you for your prompt attention to this request.

Very truly yours,

.
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