Certificates of Insurance (COI) - Certificate Request Form
The PDF version of the Certification of Insurance Request Form has been replaced by an online application that has been designed to enhance your user experience.
The application will guide you through the entire process. When you are ready to submit your request, click the SUBMIT button.
The Certificate of Insurance form is best experienced with Chrome and FireFox
Certificate of Insurance Request Enter your University Computing Account (UCA) username and password, if prompted, to begin. This is the same account that is used to log into my.pitt.edu. If you are unsure of your username and password, contact the University Help Desk at 412-624-4357.
After you have submitted your COI request, let us know what you think of the new application by submitting your comments to this email address: CertificatesofInsurance@cfo.pitt.edu
- The University does not control the issuing process; COI’s are issued by the appropriate insurance brokers for the requested types of insurance. Advance notice (preferably 10 working days) is essential due to availability of these outside partners and other factors that could hold up activity from your end. Don’t wait until the last minute!
- Additional Insured status MUST be supported by a signed contract. A signed contract between the University and the business partner triggers the additional insured status - NOT the certificate of insurance. The COI merely confirms the insurance requirements in the agreement.
- Unlike General, Automobile and Excess/Umbrella Liability policies, in most cases, a third party CANNOT be named as Additional Insured on Medical Professional Liability insurance policies
- General and automobile liability and property insurance Waivers of Subrogation preferably SHOULD NOT be agreed to in contracts since it is not in the University’s nor our Insurers’ interests to waive our respective rights to recover damages caused by another’s negligence
- Certificate requests involving STUDENT ACTIVITY approved and managed through the University must be submitted by the appropriate faculty advisor or equivalent.(Certificate requests will not be accepted directly from students.)
- LICENSED DENTISTS ONLY: IF EVIDENCE OF YOUR INDIVIDUAL COVERAGE IS NEEDED, CHECK WITH THE APPROPRIATE ADMINISTRATORS IN THE SCHOOL OF DENTAL MEDICINE AS CURRENT CERTIFICATES OF INSURANCE HAVE BEEN PROVIDED.