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.

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    • Please Issue Certificate of Insurance to:

    • *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.