Certificate Request — Solis Insurance

Your business

Tell us who the certificate is for, so we can match it to your policy.

Please complete the highlighted fields.

Business / insured name (as it appears on your policy) * This field is required. Your name * This field is required. Phone * Enter a valid phone number. Your email * Enter a valid email address. Policy number (if you know it)

Certificate holder

The company or person who is asking you for the certificate. Their name and address appear on the certificate exactly as you enter them.

Please complete the highlighted fields.

Certificate holder name * This field is required. Street address City

State ZIP

Holder’s email (where we send the certificate) Leave blank if only you should receive it.

Details & review

Last step — tell us what the certificate must show, then review everything before sending.

Please choose at least one type of coverage.

Types of coverage to show *

General Liability
The standard COI most GCs and landlords ask for. Workers’ Compensation
Proof of coverage for your employees. Commercial Auto
For your business vehicles. Umbrella / Excess Liability
Extra limits above your main policies.

Choose at least one type of coverage.

Special requirements

Additional insured
Add the certificate holder as an additional insured on the policy. Waiver of subrogation
Waive recovery rights against the certificate holder. Primary & noncontributory
Your policy responds first for the holder. 30-day notice of cancellation
Holder is notified before the policy cancels.

Job / project name or address Description of operations / exact wording requested Date needed by

Send me a copy too

Yes No

Anything else we should know?

Review your request

Your request is sent directly to Solis Insurance when you tap Send — no email app needed.

Reference:

Call 678-425-0350

Request a certificate of insurance

Your business

Certificate holder

Details & review