Directive: Requesting a Certificate of Insurance (COI)

This document outlines the essential information required by the Laurentian University Department of Enterprise Risk Management & Insurance to issue a Certificate of Insurance (COI) for your off-campus event participation, third party facilities or exhibition at a third-party event. A COI provides proof of the university's insurance coverage to external parties.

Please provide ALL applicable information below when contacting risk@laurentian.ca to facilitate a timely request.

Section 1: Your Contact Information

1. Your Name:
2. Your Department/Student Group:
3. University Email Address:
4. Phone Number:

Section 2: Event Details

1. Full Name of Off-Campus Event/Exhibition:
2. Event Date(s) (Start & End):
3. Full Address of Event Location (Off-Campus):
   (Street, City, Province, Postal Code)
4. Brief Description of University's Participation/Activities at the Event: (e.g., "Hosting an information booth for student recruitment," "Presenting research findings," "Participating in a panel discussion," "Setting up a small display for our club")

Section 3: Third Party Requiring the COI (The "Certificate Holder")

This is the organization or venue requesting proof of our insurance. (Event Organizer)

1. Full Legal Name of Organization/Venue Requiring COI:
2. Full Mailing Address of Organization/Venue:
3. Contact Person at Organization/Venue (if known):
4. Contact Email/Phone at Organization/Venue (if known):

Section 4: Specific Insurance Requirements

Please attach any available documentation from the third party asking for proof (e.g., contract, vendor agreement, email request) that specifies their insurance requirements. 

Look for details regarding:

1. Required Coverage Type(s): (e.g., Commercial General Liability)
2. Minimum Coverage Limit(s): (e.g., $2,000,000, $5,000,000)
3. "Additional Insured" Requirement:
   • Does the third party require [Your University Name] to name them as an "Additional Insured" on our policy? (Yes / No)
   • If Yes, please provide the exact wording they require:
     (e.g., "Their Name is named as an additional insured with respect to operations performed by or on behalf of [Your University Name].")
4. Specific Event/Activity Description:
   • Do they require the COI to specifically reference the event name or specific activities? (Yes / No)
   • If Yes, please provide the exact wording:

Important Notes:

• Lead Time: Please submit this request at least 10 business days prior to the date the COI is needed.
• Completeness: Incomplete information will delay the processing of your request.
• Review: The Department of Enterprise Risk Management & Insurance will review your request and may contact you for further clarification.

Submit this completed form and all supporting documentation to: risk@laurentian.ca