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Certificate of Insurance

Please allow two weeks for us to process your request.

How to Request a Certificate of Insurance

As a professional courtesy, to the underwriters, please allow two weeks for processing a Certificate of Insurance for your event.

Please complete the following COI request and email to The Risk Management office at risk@lasierra.edu

  • Who is the Certificate Holder:

    • Organization name
    • Address
    • City
    • State
    • Zip code
    • Contact Name
    • Phone number
    • Email address
  • Event location: (if different from certificate holder)
    • Address
    • City
    • State
    • Zip code
  • Activity Requiring Certificate (e.g., Filming activity: Name of film; Name of Student/ID number, phone number;)
  • Beginning Date (MM/DD/YYYY)
  • Ending Date (MM/DD/YYYY)
  • Additional Insured: Yes or No  (select one answer)
  • Specific Wording they Require
  • Sponsored by (e.g., Your Department at La Sierra University)
  • List email of recipient requesting certificate: (separate email addresses by semi-colon)
  • Name and email address of the requester

Contractors/Vendors, need to complete one of the following agreements prior to the beginning of the contracted work or event/activity:

  1. Contractor Agreement with Financial Administration
    • Contractor shall attach copies of licenses and permits to this Contract
    • Submit a Certificate of Insurance (COI)* with signed contract
  2. Vendors Agreement with Financial Administration
    • Vendor shall attach copies permits and/or licenses to this Contract
    • Submit a Certificate of Insurance (COI)* with signed contract

* Please see the Certificate of Insurance requirement form prior to obtaining a COI from your insurance provider.

Please scan and submit all required documents to Financial Administration at finadmin@lasierra.edu

To obtain Professional Liablity insurance for student internships, you may find reasonable coverage at the following resource for education based programs by contacting the:

FAQ

What is it?

A certificate of liability insurance (COI) also known as an ACORD certificate of liability insurance and serves as proof of your insurance coverage.

Why is it needed?

  • To assure the vendor or provider has adequate liability coverage.

Contact

Director Risk Management
Office: (951) 785-2102
Fax: (951) 785-2095
risk@lasierra.edu

Office Hours

Monday - Thursday
8:30 a.m. - 4:30 p.m.

Friday
8:30 a.m. - 12:00 p.m.

Office location

Administration Building
Second Floor

Report Emergency

To report a campus emergency call the Campus Security at:

(951) 785-2222

(951) 785-5222 (fax)

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