Request a Certificate of Insurance

To Request a Certificate of Insurance please fill out the contact form below and allow 48 hours for review, approval and/or completion of your certificate request. If you prefer, you can
Download the Request Certificate of Insurance Form and send the filled out form via email to info@govtechinsurance.com.


Please Issue Certificate of Insurance to:

Please select one of the following:
Additional InsuredLoss PayeeMortgageeLienholder

Please select one of the following:
General LiabilityWorkers Compensation

*If you have checked one of the choices above, please provide a complete description with supportive documentation with regard to: Location Address, Loan #, Auto Info, Equipment Item(s), Lease#. Event, Contract details including the “scope of work” for underwriting review and approval. *This documentation is required to complete the certificate request.

I have read and agree to the Terms & Conditions