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Learn about the responsibilities of the Office of Licensing and Education Services. This certificate of insurance request form template is very useful for insurance companies that provide insurance certificates.Complete and download many forms and manuals needed to complete transactions with the SCDMV. Commercial insurance clients of Horst Insurance may use the form below to request that a Certificate of. Insurance (COI) be issued on their behalf. Submit a request for a certificate of insurance using the form below. To request a Certificate of Insurance for a university, mortgagee, bank, or loss payee, please complete the Non-Event Certificate of Insurance Request Form. NAME INSURED INFORMATION (If requesting on behalf of a USA Archery Club, please list club name. Application for Certificate of Authority for a Multiple Employer Self-Insured Health Plan (MEWA) (MO 375-1804). In order to have a certificate issued, please complete Certificate of Insurance Request Form and submit it to USU Risk Management.