Certificate of Insurance for the Ministry of Transportation and Infrastructure

This Certificate of Insurance form is applicable specifically for the Ministry of Transportation and Infrastructure.

For instructions and assistance when completing this form, hold your cursor over the fields of the form. Both pages 1 and 2 are required for submission.

IMPORTANT: This Certificate of Insurance must be submitted fully completed and without any alteration or change made to the terms and conditions set out in this certificate.

Any alteration or change to the terms and conditions set out in this certificate will likely render the certificate null and void. The Ministry of Transportation and Infrastructure will then likely reject the certificate.

The ministry will consider scanned ministry Certificates of Insurance as originals but the certificates must be emailed directly from an authorized representative of the insurer. Scanned versions from contractors or any other source will not be considered original.

• Complete the Ministry Certificate of Insurance H-0111