Service Center

Certificate of Insurance Request

You now have the option of requesting certificates of insurance on the following electronic form. It is important to include as much information as possible. We will review your request, contact you if further information is required, and then send the certificate of insurance to the appropriate party(s).

Please Contact Our Office Regarding OCIP or CCIP Projects.


General Information
Name of Insured:
Insured Phone:
Name or Company of
Certificate Holder:
Job Reference No.:
Address of Holder:
City: State: Zip:
Holder Phone:
Holder Fax:
Your Name:
Contact E-mail Address:
Handling Method:

Required Coverages
Please provide copy of insurance requirements of contract:

Auto
Umbrella
General Liability
(provide job description below)
Equipment
Workers' Compensation
Builders Risk

General Liability Description:
Arizona
California
Colorado
Florida
Georgia
Idaho
Kansas
Nevada
New Hampshire
North Carolina
Ohio
Oklahoma
Oregon
Pennsylvania
South Carolina
Tennessee
Texas
Utah
Washington
Wisconsin
Wyoming
1111 E Draper Pkwy, Ste 206 Draper, UT 84020
801.590.4500
801.590.4466
info@thegiginc.com

Monday - Thursday: 9am - 5pm
Friday: 9am - 4pm
Saturday - Sunday: Closed

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