Office of Insurance, Loss Control & Claims
Request for Certificate of Insurance
This form is for the use of  recognized student groups who have a student organization account and  IU departments.
It may also be used by  student groups/organizations recognized by IU other than .
Many certificates of insurance can be issued without cost for Category  groups. If there is a cost you will be invoiced by INLOCC.
Category  groups will not be charged unless the event is deemed high risk (there could be an additional cost). You must include an account number.
Please note: Some events (those that are unusual or higher hazard - such as a large concert or aerial activity) are subject to the insurance carrier's review and acceptance. You will be notified if there are issues that must be addressed.
All certificates requested by Category  will have a cost that you must pay.
If there is a cost for the certificate you will have the opportunity to accept or decline the coverage before it is finalized. That message will come from INLOCC.
Please allow 10 working days to obtain the certificate. Allow 30 days if this is a significant event such as a large concert.
Attention IU departments: Contracts must be processed by Purchasing. Please forward the contract to them. They shall not be signed by you. Read the contract language to answer questions below.
Please review the form to ensure you have all required ( * ) information.