Click on the following link to download a copy of Attachment C: Request for Certification of Insurance. You will need Adobe Acrobat Reader to access the form.
Attachment C: Request for Certificate of Insurance
Complete and fax the Request for Certification of Insurance to Risk Services in Oakland at (510) 987-0965.
Be sure to include the name and address of the party being insured, and the amount of insurance limits the insured party is requesting. If you do not know the amount of insurance and it is not written on the contract, call the other party and ask them to ask their insurer.For questions regarding the processing or submittal of a Request for Certification of Insurance, contact Linda (Oristine) Harris at (510) 987-0085 or
oristine.harris@ucop.edu.