Certificate of Liability Insurance: How to Request + Sample

Cody Cromwell
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What Is a Certificate of Insurance

A Certificate of Insurance is an official form used to verify that your insurance policy includes what you’re looking for in terms of coverage. Your insurance agent will ask you to sign a format specified by the policy they’re selling you.

A Certificate also plays a critical role in recording the terms and conditions of any insurance agreement. An insurance certificate is basically a declaration of the coverage you’ve purchased and the coverage options outlined.

For example, a certificate of insurance would be found in the Coverage Section of a liability policy written for individual contractors.

The certificate of insurance usually mentions the terms and coverage details of the policy in general and highlights specific features of the policy. It also reveals the party protected against loss, the authorized entity, and the insured property.

When to Get a Certificate of Insurance

Before you start building, learn about the various types of construction insurance available. Here are some questions you should ask when deciding which insurance you need.

What building risk am I insuring?

What is the value of my building?

Will the project be completed by the deadline?

Will I have all of the required permits?

What is the maximum dollar amount of replacement costs for my building?

You can find answers to these as well as other questions by searching your zip code on the Nationwide PERI website. This website helps you build a profile of your home construction project and match it to types of insurance.

You should also check out this Insurance Search Guide produced by the Insurance Information Institute. This guide is designed to help you compare and understand the major types of home insurance coverages.

The most common home construction coverages include:

How to Request a Certificate of Liability Insurance

If you run a business, you probably know that you need business insurance to protect your assets. But did you know that you also need a Certificate of Liability Insurance? This is a form that evidences that your business has commercial liability insurance that is sufficient to cover business activities and that there are no outstanding claims. Without it, businesses will not be listed in the Insurance Directory.

To request a Certificate of Liability Insurance, your business must have an active insurance policy with an insurer that is licensed to do business in the U.S., and who agrees that your insurance is sufficient. You can get more information on your requirements by visiting our Business Insurance Guide and use that as the basis for developing your Certificate of Liability Insurance.

Sample Certificate of Liability Insurance Template


Greetings from LegalZoom. Our business name is _____ and our physical mailing address is _____. We are the owner(s) of the business, and have been authorized by written authority to act as agent in all matters pertaining to the business.


This certificate of liability insurance (the "insurance certificate") is issued by __________, as the insurer to the business for which it is issued.. . .

Certificate of Liability Insurance Sample

Our Sample Certificate of Liability Insurance Presentation is designed to help you request Certificate of Liability Insurance. The following text is from the Sample Certificate of Liability Insurance (this example has been edited and provided to present a sample of what you could include in your own Certificate of Liability Insurance):

Because of the growing popularity of mountain bikes that are modified and built specifically for trail riding, the proliferation of improving quality, and the lack of nationwide/international standardization of equipment with respect to claimed liability, we are writing to you to suggest that the group be named a “Special Interest Group”

The specific purpose of the Group would be to develop innovative techniques and devices that are protective, and that are mandatory in the Manufacturers’ manuals. The purpose of this letter is to introduce this proposal. Several manufacturers of Mountain Bikes have indicated that they are willing to be represented by a group such as this, should the need develop.

James A. Garfield, Co-Chair

Clark College Storm Water Services Committee Chairman

Co-Chair, Garfield Mountain Bike Special Interest Group.

12875 SW US Highway 20

Hillsboro, OR 97124.

Table of Contents

Section 1 – Purpose and Authority.

The purpose of this Certificate is to provide the insurance company with a statement of the fact that a risk is being assumed.

Section 2 – Insurance Company.

Certificate of Liability Insurance Form Explanations

If you are a business owner, your business may offer your customers certificate of liability insurance. Certificates of liability insurance should be clearly printed with the business name, the insurer identification information (license number,etc.), the policy number, the effective date, a description of the coverage, the amount of the insurance, and the expiration date. Certificates of Liability Insurance forms must have a separate space for the business name and address of the insured and the business contact information. If your business isn’t regulated by the Department of Insurance you can use a form based on Model Contract Form 15 (sample of Certificate of Liability Insurance).

Always make sure that you fill out the Certificate of Liability Insurance form carefully and correctly. Use a carbon copy or a photocopy to avoid any problems. Don’t forget to notarize or seal the document. Don’t forget to keep your Certificate of Liability Insurance form in an effective file.

If you like to receive more information on Certificate of Liability Insurance, check out a detailed explanation. Through this guide, you will be well familiar with the term “certificate of liability insurance” and have also learned how to request a certificate of liability insurance.



And Distributor Certificate of Liability Insurance:

Producers and distributors who want to work in the Adult Industry are required to carry liability insurance.

The Certificate of Liability Insurance cover has to be obtained from Protect America.

In order for Protect America to approve the Producer and Distributor Certificate of Liability Insurance, the following document from the Producer or Distributor must be sent to Protect America directly:

{1}. The Producer and Distributor’s Original Identification and Address Documents for both the Producer and the Distributor.
{2}. The Producer and Distributor’s Proof of Insurance coverage papers dated within the previous 12 months.
{3}. Any and all relevant communications from either the Producer or the Distributor to Protect America asking for the Certificate of Liability Insurance to be renewed or renewed.


Public parks are typically designed to host a variety of purposes for both scheduled and spontaneous use. Parks typically are open to the public during daylight hours.

A playground is any designated area within a park that features play equipment for children. Playgrounds are designed to provide a safe environment for children to engage in play while being supervised at all times by adults.

A public playground is any park maintained or operated by a public agency where the public is allowed to play at certain times or for certain purposes.

In many cases, there is a purpose for a public playground, such as encouraging physical fitness through organized sports. However, there is not a specific design criterion for these playgrounds. The intended function of a playground is determining what and how play is to be facilitated.

A playground usually has one primary purpose that is clearly stated on the playground sign. This primary purpose does not necessarily mean that there cannot be another purpose.

Some examples of this purpose include a dedicated playground for activities like gymnastics, dance, martial arts, etc. Or as a playground structure intended to support casual sport or leisure activity such as kickball, tennis, etc.

Examples of non-primary purposes include preschool programs, gymnasiums, skateboard parks for providing opportunity for skating, etc.

We can define a public playground as a playground facility that is available to the public.

Insurers Affording Coverage

If your business employs two or more people who do work away from your business (as some types of home businesses do), you’ll need to purchase an employer’s liability policy from a specialized insurance company.

Although this kind of policy is relatively inexpensive, it’s important that you find an insurer to whom you’re comfortable entrusting your business. You can check with your homeowners or landlords’ insurance agent for recommendations.

If your business is family run and employs only you and your spouse as writers, freelancers, consultants, or contractors, your personal homeowners or landlords’ insurance policy will suffice. (If you and your spouse are both homeowners, it’s pretty much a given that both of you are covered).

However, if you require an employer’s liability policy, insurance companies are permitted to offer coverage to businesses with a single employee provided that the business specifically requests it. Your insurer may quote you a higher premiums for this coverage, but owners appreciate the peace of mind that it provides.


Description of Operations, Locations & Vehicles

The Certificate of Liability Insurance issued by United Services Automobile Association is a standard liability insurance document that protects the person or people operating a vehicle from injuries to the property of others.

Before this insurance was required by law, you were only required to have a general liability insurance policy to cover bodily injury and property damage. In 1964 these two types of insurance were merged together to become a comprehensive (property and bodily injury) general liability policy.

Every policy includes a number of provisions called the standard liability coverages, like the following:

Liability Insurance

Conduct of Business. This covers the liability you might face for death or bodily injury while on your business premises at a time when nobody is there to supervise you.

Trucking. This covers your own truck if another person is driving it and it damages someone else’s property.

Premises Liability. This covers property damage at your business location like when a customer slips and falls and sues you.

Property Liability. This includes property damage to the person or property of the company, customers and employees when a company-owned vehicle is hitting or hitting an object.

Product Warranty. This covers your liability for the faulty product that you sell as all products are sold with some kind of warranty.

Certificate Holder

A Certificate of Liability Insurance is a form that provides rental property owners with insurance coverage for bodily injury and property damage caused by their tenants and any guests, residents, invitees, or employees. This form is required for nearly all residential rental properties and is also usually required for commercial properties.

Certificates of Liability Insurance also help protect the landlord from lawsuits filed against them, and the landlord should make it clear to all prospective tenants that they will receive one upon signing a rental agreement.

The certificate holder is the insurance company that you list on the rental application. However, the landlord is the person named on the policy, and if a conflict develops between the landlord and the certificate holder, it’s the landlord who ends up paying the individual responsible for the injury.

Legally, a landlord may be liable to the tenant if the landlord is negligent or otherwise breaches a duty that is assumed under the rental agreement. This liability may arise from failing to provide adequate security, inadequate upkeep or property maintenance, property maintenance and safety hazards, and the landlord’s failure to maintain or comply with local, state, or federal building or safety codes.

The tenants are also responsible to maintain their property and may be sued if they are negligent. In many cases, however, if the landlord is also negligent, the tenant will not be able to recover damages in a lawsuit.


Upon receipt of this Certificate, the named Certifying Officer shall make or cause to be made an appropriate notation of this cancelation/termination upon the Certificate of Liability Insurers' records.

When the Certificate of Liability for an Employer is canceled/terminated, the Employer shall submit a Certificate of Liability Insurance showing no Employer or Liability Insurer listed thereof.

Upon receipt of this Certificate, the named Certifying Officer shall make or cause to be made an appropriate notation of this cancelation/termination upon the Certificate of Liability Insurers' records.

When the Certificate of Liability for an Employer or other property is canceled/terminated, the Employer or other property shall submit a Certificate of Liability Insurance showing no Employer or Liability Insurer listed thereof.

Upon receipt of this Certificate, the named Certifying Officer shall make or cause to be made an appropriate notation of this cancelation/termination upon the Certificate of Liability Insurers' records.

When the Certificate of Liability for an Employer or other property is canceled/terminated, the Employer or other property shall submit a Certificate of Liability Insurance showing no Employer or Liability Insurer listed thereof.

How to Cancel/Terminate Insurance Coverage.

Authorized Representative

Or Signature Required According to the Real Estate Settlement Procedures Act, once the real estate agent has sold the real estate property, they will then have to request and obtain the signature of a limited liability company representative or owner to indicate the limited liability company is liable.

So the signature of someone on behalf of the limited liability company must be recorded. This is typically the secretary or similar official figures who have the authority to sign on behalf of their organization.

What is required in the requirements in the REALTOR version of the CMAR are presented in the following format.

  • Authorized Representative or Signature Required
  • In accordance with RCW 32.24.300 through 32.24.590, a real estate licensee, as defined in RCW Title 32, chapter 17.91, shall not use a real estate license in connection with the disposition of real estate unless the licensee has furnished to the purchaser a certificate evidencing that the licensee has complied with the provisions of RCW Title 32, and the secretary of the department of financial institutions has approved such compliance as evidenced by a certificate of compliance issued by the secretary to the licensee pursuant to RCW 32.24.300.
  • All designated representatives must keep an original hard copy on file or prominently display a photocopy of the CMAR for their personnel to refer to whenever they must sign for the limited liability company on behalf of the general partner.

When to Add Certificate of Liability Insurance Certificate Holders

That are CSO’s, or Certificate Specialists Officer, are held to the exact same standards as CCO’s. Both classes of officers, as well as their heirs, depend on the certificate of liabilty to protect them from potential lawsuits. Because of this, some states require that the certificate holder request an endorsement to the certificate of liabilty, which certifies that the person is a CSO.

The standard format for a standard certificate of liability is as follows:

In any CSO Certificate of Liability, the following data elements must be updated:

Certificate Holders must also make sure to:

The state of California requires a Certificate of Liability to be furnished for every insurance policy, unless the policy contains an exemption. The endorsement must contain the following data:

The endorsement must be signed and dated by the insurer or the insurance agent of the insurer issuing the policy. The endorsement must bear the seal of the issuing insurance company when the policy was written, and its endorsement must be stamped in red ink on all copies of the policy, except where an insurance certificate of deposit has been used. The certificate of liability must also contain a statement signed and dated by the insurer or the insurance agent of the insurer, stating that the insurer or insurance agent has been furnished with the CSO certificate of liability, as heretofore required by the state of California.

Liability Insurance Certificate Holder Examples

Do not end up in jail <==> you will need your certificate with you and READY when you enter a courtroom for court, or have police coming to your workplace.

It is absolutely vital that you have a liability insurance certificate if you have been doing any work in a commercial property. You will need your certificate with you and READY when you enter a courtroom for court, or have police coming to your workplaces.

This article explains exactly what you need to do to get such a certificate and the costs involved.

Different Businesses Warrant Their Employees with Certificate of Liability Insurance

A liability insurance certificate is a document that proves that you have covered by an insurance company. It is issued by a company who guarantees that you have covered by insurance. Who is mandated to carry liability insurance?

When you go to work or to run a small or big business, the landlord requests you to provide your liability insurance certificate. If your company does not carry this certificate, the landlord can ask for your key and they can close your company door.

The reason for this is because such a certificate is your guarantee that you have covered by insurance. You need to show the certificate to any judge whom you have to work before. If you have not shown the certificate, probably you are in a court as an accused.

Certificate of Liability Insurance Frequently Asked Questions (FAQs)

Here are the most frequently asked questions pertaining to Certificate of Liability Insurance.

What is Certificate of Liability insurance?

Certificate of Liability insurance, sometimes referred to as general liability insurance, covers you from damages you may potentially incur from harm caused by the actions of another person on your property. It’s a common type of insurance and is available either as a stand-alone coverage or as part of a package. The insurance protection extends from, and can include, property damage, bodily injury and personal injury.

How much is Certificate of Liability insurance?

Certificate of Liability insurance is available as stand-alone coverage as well as a part of a package. The price of the insurance will vary widely depending on many factors, including the type of hazard for which the coverage is needed and the nature of business being conducted. Under normal circumstances, the insurance premium will be comparable to the amount of business you have and insure. In a business that’s highly risky or involves extensive assets and high-value transactions, the insurance coverage premium will likely be more expensive, while a more established business that has a lower risk of potential losses may be able to avail a cheaper insurance coverage premium.

If you already have a liability insurance, what will Certificate of Liability insurance do for you?

Why is my client asking for my certificate of insurance?

Many of our clients, especially those working with property investors and developers, ask for a certificate of insurance when they are meeting with investors, purchasers, buyers, lenders, business partners and soon-to-be vendors.

One of their main concerns is about getting an unfair negotiating position with the solicitors when negotiating on behalf of their clients.

We have always advised them to carry out their own research first and then get in touch with their clients and just talk about the terms and conditions of the certificate of protection. We now embrace the fact that many of our clients are doing this and most are happy with the document that the client has provided them with.

If you are a client of a property solicitor or surveying or quantity surveyor and you are a vendor or a potential purchaser, you should always check their certificate of insurance before you accept their services.

How much does a certificate of insurance cost?

Certificates of Liability Insurance are affordable online and ready to print or view online. You can request a certificate of liability insurance from your insurance provider or online through your insurance provider.

Bottom Line: Certificates of Liability Insurance

Keep your business from loss based on fault or tort.

The Certificate of Liability Insurance protects your assets. The policy is intended for bodily injury or property damage claims. By fully insuring your promises and assets against the rare occurrence of a lawsuit, the business gains a higher level of acceptance from customers and other tradespeople.

In turn, the insurer is relieved from the financial burden of handling and paying a claim. The loss prevention product offers customers peace of mind that their products are rest assured to be free from frivolous lawsuits and liability claims.

You can purchase this type of insurance from insurance providers in the United States. A Certificate of Liability Insurance is not insurance per se. It is a defense against a lawsuit, claiming that the insured neglects to honor a promise to the consumer or to the public. This liability insurance policy is primarily used in the case of a liability insurance claim.

The good thing about the Certificate of Liability Insurance is that it has unlimited coverage for the liability coverage against damages or injuries. The Certificate of Liability Insurance is not meant to fix or cover any damages that are already incurred by the damage or injury.

§ The purpose of the certificate of liability insurance is to protect customers of your products or services in case there is unnecessary or malicious actions and/or negligence against the business.