Certificate of Insurance

Your Information

Reason for Certificate Request

Customer/Certificate Holder Contact Information

Separate multiple addresses by commas

Describe types and limits of coverage required if standard certificate is not adequate

Auto Liability

General Liability

Workers' Compensation / Employer's Liability

Cargo Liability

2464 maximum characters

One-time Deliveries (XPO Last Mile & XPO Courier)

2464 maximum characters