Request a Certificate

A certificate holder is a third party, typically a person, business, or entity that receives your Certificate of Insurance (COI) as proof that you have active insurance coverage. They are typically clients, landlords, or general contractors verifying that a vendor, subcontractor, or tenant has the proper liability coverage.

Complete the following fields to request a certificate from Lockton Affinity. We will send your certificate within two business days. Questions, call us at (913) 652-7500.

Policy or account number

Business name

Your name

Your email address

Your phone number

Certificate holder name

Certificate holder address

Certificate holder city

Certificate holder state

Certificate holder zip

Certificate holder relationship to insured

Certificate request type
One-TimeAnnual

Required by contractYesNo

Type of certificate (select all that apply)
Proof of CoverageAdditional InsuredLoss PayeeLender’s Loss PayeeMortgagee

Message (Ex. Contract specifics, location address, etc.)