Free operator toolkit
Free certificate of insurance request template (COI request form)
The request an operator sends their insurance agent to get a certificate issued for an event. It carries your policy details, the certificate holder exactly as the venue spells it, any additional-insured or special wording they demand, the event and the operations it covers, the limits from their requirements sheet, and the date you need it by. Fill in the brackets and email it.
This template is general information, not legal advice. What a document like this can and cannot do varies by state, so have a local attorney review your final version before you use it.
Updated August 2026
Certificate of Insurance: Request to Agent
Fill in every bracket and send this to your agent or broker. Attach the venue’s requirements sheet or contract page if you have one. It answers most of the questions below better than you can paraphrase them.
1. Send to
Agent or broker: [name] · [agency].
Email: [email] · Phone: [phone].
Subject line to use: Certificate request · [your business name] · event [date] · needed by [date].
2. From (the insured)
Named insured, exactly as it appears on the policy: [legal business name].
DBA, if the venue knows you by a different name: [trading name].
Mailing address: [address].
Contact for this request: [name] · [phone] · [email].
Policy number(s): [general liability policy number]. [Other policies, if the venue asks for them: commercial auto, umbrella, workers’ compensation.]
Policy period: [start] to [end].
3. What I am asking for
Please issue a certificate of insurance evidencing the coverage below for the event described in Section 5, and send it to me, and, if you send it directly, to the certificate holder in Section 4.
I need it by: [date]. The event is on: [date].
Number of certificates needed: [count]. [Some venues want one for the park and one for the city.]
4. Certificate holder
Copy this from the venue’s requirements sheet, character for character. A certificate naming the wrong entity gets rejected and you start again.
Certificate holder legal name: [exact legal name].
Address: [street] · [city, state ZIP].
Attention / department: [name or department].
Their reference for this event, if they gave one: [permit or reference number].
5. Event and operations covered
Event name: [name]. Date(s): [date(s)]. Hours: [start] to [end].
Location: [venue name] · [full address].
Description of operations, as the venue words it if they specified one: [for example, delivery, setup, supervision, and removal of inflatable amusement equipment].
Units on site: [names and count]. Attendant provided: [yes · no].
Estimated attendance, if the venue asks: [number].
6. Limits requested
Copy these from the venue’s requirements sheet. Do not state a limit you have not confirmed with your agent. A certificate showing coverage you do not carry is a problem for you, not for the venue.
General liability, each occurrence: $[amount as required].
General aggregate: $[amount as required].
Products and completed operations aggregate: $[amount as required].
Damage to premises rented: $[amount as required].
[Any other coverage the venue lists: commercial auto, umbrella or excess, workers’ compensation, abuse and molestation: $[amounts as required].]
If my current limits are below anything above, please tell me what it would cost to raise them for this policy period rather than issuing a certificate that does not meet the requirement.
7. Additional insured and special wording
Attorney review recommended
CONFIRM THIS SECTION WITH YOUR AGENT BEFORE YOU PROMISE IT TO THE VENUE, and have your attorney read the venue’s contract clause if one is attached. A certificate EVIDENCES a policy; it does not create coverage. Additional-insured status, waiver of subrogation, and primary-and-non-contributory wording are policy ENDORSEMENTS: your agent may need to add them, they may carry a premium, and the carrier may decline. Asking for them on a certificate that the policy does not actually carry is the most common way this goes wrong.
Additional insured requested: [yes · no]. If yes, name them exactly as the venue writes it: [exact legal name(s)].
Basis requested by the venue: [ongoing operations · ongoing and completed operations · as their contract requires; quote it].
Waiver of subrogation requested: [yes · no].
Primary and non-contributory wording requested: [yes · no].
Notice of cancellation requested: [days, as the venue requires].
Any other wording the venue demands, quoted verbatim from their document: [paste it here].
Please confirm which of the above the policy already carries, which need an endorsement, and what any endorsement costs, before the certificate goes out.
8. Delivery
Send the certificate to: [your email].
Also send directly to the certificate holder: [yes · no]. If yes: [their email or portal].
The venue requires submission through a portal: [yes · no]. If yes: [portal name and link].
Please copy [name] at [email] on the issued certificate.
9. Sign-off
Thank you. If anything above is unclear or cannot be issued as requested, please call me at [phone] rather than sending a certificate that will be rejected.
Requested by: ______________________ Date: __________
[Your name] · [title] · [business name]
How to use this template
Sooner or later a park, a school, a church, an HOA, or a corporate client will email you a requirements sheet and ask for a certificate of insurance before you can deliver. The certificate itself is your agent’s job. Yours is to ask for the right thing, with the right names on it, early enough. Here is how to use this request. If you want the background on what a certificate is and what the terms on it mean, read the companion guide on certificates of insurance for events.
Send it the day you are asked, not the week of the event
Certificates are usually quick, but "usually" is doing real work in that sentence. A plain certificate against coverage you already carry often comes back the same day or the next. One that needs an additional-insured endorsement added to the policy can take days, because it is a change to the policy rather than a piece of paper.
Venues also enforce their own deadlines, and a surprising number will not let you on site without the certificate on file: no certificate, no delivery, deposit conversation to follow. Forward the requirements sheet to your agent the day it lands.
Copy the certificate holder exactly, and do not tidy it up
This is the single most common reason a certificate gets bounced back. The venue is "City of [somewhere], Department of Parks and Recreation, and its officers, agents, and employees" and the certificate says "[Somewhere] Parks". Same entity, rejected certificate, two days lost.
Copy and paste from their document. Keep the commas, keep the "and its officers, agents, and employees", keep their address exactly. If they gave a permit or reference number, put it on. Tidying the name up is a kindness nobody asked for.
Understand what a certificate does before you promise anything
A certificate of insurance is evidence. It says a policy exists, who it covers, what the limits are, and when it expires. It does not create coverage, it does not change your policy, and an agent cannot type coverage onto it that the policy does not carry.
That matters most for the three things venues ask for by name: additional-insured status, waiver of subrogation, and primary-and-non-contributory wording. Each is an endorsement to the policy itself. Your agent may add them, may charge for them, and may come back and say the carrier will not. Find that out before you tell the venue yes, which is exactly what the last line of Section 7 asks your agent to do.
Do not request limits you have not confirmed
Section 6 is deliberately all blanks. Copy the numbers from the venue’s requirements sheet, then let your agent tell you whether your policy meets them. If it does not, the useful question is what it costs to raise the limits for the policy period, often less than an operator fears, and always cheaper than losing a venue that could send you work every summer.
What you must not do is guess a figure because it looks like a normal one. A certificate stating coverage you do not carry is a document with your name on it that is wrong, and the moment it matters is the worst possible moment to discover it.
Ask for the number of copies you actually need
Municipal work often needs two: one naming the parks department, one naming the city. School districts sometimes want the district and the individual school. Corporate clients may want the operating company and the property manager.
Read the requirements sheet for how many holders it names, and ask for all of them in one request. Going back to your agent three times for three certificates in one week is how you become the client whose emails wait.
Keep the issued certificate with the booking
When the certificate comes back, save it against that event, not in a general insurance folder. Check three things before you file it: the holder’s name matches their sheet, the dates cover your event, and any wording you promised is actually on it.
Then diarize the policy expiry. A certificate is only good while the policy behind it is in force, and the operator who books a September event in June on a policy that renews in August is the operator who gets a call from the venue the week before.
Reuse the request, change the four fields that move
Most of this document is the same every time: your named insured, your policy numbers, your contact, your operations description. Four things change: the holder, the event, the limits, and the wording they demand.
Save a filled copy with your details already in it and edit those four for each venue. It turns a twenty-minute email into a two-minute one, and it stops the mistake where last month’s park is still sitting in the certificate holder box.
Keep your paperwork in one signed place
On Solo and up, BounceDay builds your own contract, waiver and weather policy into one document your customer e-signs, then takes the deposit at signature by card or bank transfer, or on your own payment links. Your templates stay yours. Adapt them, send them, and keep every signed copy on the booking it belongs to.
Frequently Asked Questions
Is this certificate of insurance request template free to use?
Yes. The full request is on this page and you can copy it or open a printable version to save as a PDF. No email required. Fill in the brackets and send it to your agent or broker.
Does a certificate of insurance create coverage?
No. A certificate is evidence that a policy exists: who is insured, what the limits are, and when it expires. It cannot add coverage to a policy. Additional-insured status, waiver of subrogation, and primary-and-non-contributory wording are endorsements to the policy itself, which your agent may need to add, may charge for, and may not be able to obtain. Confirm all of it with your agent before you promise it to a venue.
How long does it take to get a certificate of insurance?
A plain certificate against coverage you already carry is often issued the same day or the next. One that needs an endorsement added to the policy takes longer, because the policy is being changed rather than described. Send the request the day the venue asks, not the week of the event.
Why did the venue reject my certificate?
Most often the certificate holder’s name does not match their paperwork exactly, the limits are below what their sheet requires, the dates do not cover the event, or a wording they demanded, usually additional insured or primary and non-contributory, is missing. Copy their entity name character for character, and ask your agent to confirm each requested wording is actually on the policy before the certificate goes out.