Certificates of Insurance

Dixon High School

Certificates of Insurance

Frequently your site will be asked to provide companies or other agencies with evidence of your district’s insurance coverage, typically referred to as a “Certificate of Insurance.” NBSIA arranges for the certificates to be issued.

*PLEASE NOTE:  Certificates are not issued directly out of the NBSIA office and can take as long as five working days to produce.  Please allow enough time when making a request.


These certificates by themselves provide information only to the requesting party, including the types of coverage held, name of the insurer, expiration dates and limits.  There should also be a description of the event being covered, and any other pertinent information.

Should a request be made for an “additional insured endorsement,” a separate page is included with the certificate.  This page endorses the requesting party onto the district’s policy, and should any loss occur as a result of the relationship between this party and the district, NBSIA will be called in to cover that loss.  Obviously, this endorsement is not one that should be taken lightly, and a close review of the district’s agreement with the other party should be undertaken before the endorsement is issued. 

Procedures for Requesting a Certificate and/or Endorsement:


  • Fax or mail a copy of the contract/agreement between the district and the vendor to NBSIA.
  • If the agreement does not specify the following information, please add it on a separate sheet:
    • For Special Events:
      • Who: Name and address of vendor or venue requesting the certificate
      • When: Date and time of event
      • Why: Description of event or activity
      • What: Description of participants
      • Where: Location
    • For Property (i.e., portables, photocopiers, vehicles):*
      • Make, model, and year
      • Description (size)
      • Lease or loan number
      • Value of equipment
      • Serial number
      • Loss payee if applicable
      • Location of equipment
      • For busses:  # of passengers
  • Indicate any special circumstances or requests.
  • Provide the name of an individual at the district who can answer questions we may have.


Upon receipt, we will review the agreement and begin processing the certificate.

WARNING:  Rental interruption protection is frequently one of the coverages required in a lease agreement or certificate of participation.  This coverage is not automatic and requires specific endorsement of the leased property onto our policy.  If your contract requires this coverage, please make this clear to NBSIA.

Use the links below to view sample certificates:

Sample Certificate of Liability (including Additional Insured Endorsement)

Sample Evidence of Property Insurance (including Loss Payee Endorsement)


Third Party Coverage Resources:


Occasionally, outside groups will request use of Member facilities. In addition to completing the required Facility Use Agreement, they must provide their own liability coverage when using Member facilities. Such groups should have at least a $1,000,000 liability policy in place to protect them and the Member in the event of a loss.  The Member should also be named as an additional insured on the policy. There are commercial insurance programs designed specifically for this purpose which are available through independent brokers, such as those listed below: 

R. V. Nuccio &Associates: http://www.rvnuccio.com/

NICO:    https://www.nationalindemnity.com/Products_SpecialEvents.aspx

Please note, special event insurance is a specialized sector of liability insurance and can be purchased through most major carriers. The references above are provided as a courtesy and should not be interpreted as an endorsement.