Washington State University
BUSINESS POLICIES AND PROCEDURES MANUAL

SAFETY AND SECURITY
50.11
Revised 11-06
Risk Management and Insurance
335-6893

Certificate of Insurance

PDF link

OVERVIEW

Occasionally, the University must provide evidence of insurance coverage to third parties. Such evidence is generally called a Certificate of Insurance. The third party may be named as additional insured under WSU's self-insurance program or other insurance policies. See also EP6: Policy on Risk Management.

WSU's liability for the negligent acts of its employees is covered through the State of Washington Self-Insurance Liability Program (RCW 4.92, et. seq.) administered by the state's Office of Financial Management (OFM), Division of Risk Management (DRM). The coverage only applies when non-University employees or their property are injured or damaged due to the negligence of a WSU employee or agent. In order for the coverage to apply, the employee or agent must be acting in good faith on behalf of WSU and within the scope of the duties assigned to the individual by WSU at the time the loss occurs.

The WSU Office of Risk Management and Insurance processes and submits all University requests for Certificates of Insurance to the DRM for issuance.

Event, Function, Provision of Services, or Use of Facility

When a WSU department holds an official event, function, provides services, or otherwise uses an organization's facility for official purposes, that organization may require evidence of insurance coverage obtained by the University.

Student-Sponsored Events

Student-sponsored events are excluded from WSU's liability insurance. The DRM does not issue certificates of insurance for such activities.

REQUEST FOR CERTIFICATE OF INSURANCE

To obtain a Certificate of Insurance, complete and submit a Request for Certificate of Insurance to the Office of Risk Management and Insurance. Print the master form on 50.11.3 or complete onscreen and print.

Required Information

Include the following information on the Request for Certificate of Insurance:

Requesting Department

Enter the requesting department name, address, telephone and fax numbers, e-mail address, and the name of the primary contact individual.

Third Party

Enter the third party organization name, address, telephone and fax numbers, e-mail address, and the name of the primary contact individual.

Period of Insurance Coverage

Enter the beginning and ending dates and times of the event, function, provision of services, or facility use.

Location

Enter the location or site where the event or provision of services will occur.

Description

Enter a brief description of the event, function, provision of services, or facility use.

Attach Agreement

Attach a complete copy of the contractual agreement applicable to the event, function, provision of services, or facility use.

RECEIVING CERTIFICATE

The Washington Division of Risk Management sends the original of the certificate directly to the third party and a copy to the Office of Risk Management and Insurance.

See the PDF master form:
50.11.3: Request for Certificate of Insurance
Complete and/or print as needed