Certificates of Insurance (COI) - Certificate Request Form
Certificate Request Form - Submit to CertificatesofInsurance@cfo.pitt.edu.
- Please provide advance notice of at least ten (10) working days. Don't wait until the last minute. Either we or the brokers who issue the certificates may not be available or changes may be needed to the certificate(s) issued. This could hold up activity from your end.
- 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
- Indicate the effective dates of the contract for a multi-year agreement so that the certificate(s) can be automatically renewed.
- General Liability 'Waivers of Subrogation" cannot be agreed to in contracts. The University's Primary General Liability insurer does not allow waiving their rights to recover damages caused by another's negligence.
- Certificate requests will not be accepted directly from students. The appropriate advisor/department head must request.
NOTE: The submit button on the Certificate Request Form will work for Adobe Acrobat DC users only. Adobe Reader users will need to print/scan/email the request form to CertificatesofInsurance@cfo.pitt.edu.
- 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.