Proof of Insurance Certificate

Paychex Insurance Agency provides you with a quick, easy method to obtain a Certificate of Proof of Insurance* on our site.

If you are a Paychex Insurance Agency customer, please fill out the requested information below to request a certificate of insurance.

Does this require a Waiver of Subrogation?

Please contact Paychex Insurance Agency at 877-266-6850, option 20 to process your waiver of subrogation. Waivers require specific information and may be subject to a fee. Thank you for allowing us to serve you – we value your business!

Type of Certificate

Policy Holder

Please fill out the requested information below. In order to fulfill this request all required fields below need to be completed.

1. Certificate Holder

Do We Need to List Additional Insureds?
Do You Have a Written Contract with the Certificate Holder?

2. Certificate Holder

Do We Need to List Additional Insureds?
Do You Have a Written Contract with the Certificate Holder?

3. Certificate Holder

Do We Need to List Additional Insureds?
Do You Have a Written Contract with the Certificate Holder?

4. Certificate Holder

Do We Need to List Additional Insureds?
Do You Have a Written Contract with the Certificate Holder?

5. Certificate Holder

Do We Need to List Additional Insureds?
Do You Have a Written Contract with the Certificate Holder?

Certificate Delivery

Send Certificate Via
Send Certificate To

File Attachments

Maximum 3 files.
256 MB limit.
Allowed types: pdf doc docx.