Bob's Discount Furniture - Request COI

Request a Certificate of Insurance

If your building requires a Certificate of Insurance for deliveries, complete this form 72 hours before the scheduled delivery date. Once submitted, we will process and send the completed Certificate of Insurance to the building as provided on the form.

Requests received less than 72 hours before a scheduled delivery date may cause delays in the delivery. To avoid delays, follow these tips:

A scheduled delivery date is required before making a request
If the delivery date changes, submit a new request
Ask for guidance from the Landlord or the building property management to ensure all information is correct
Requests are processed Monday through Friday, during normal business hours

For assistance with delivery dates, please contact Customer Support

Customer / Delivery Details:

Please enter the Scheduled Delivery Date

You must have a scheduled delivery date in order to request a Certificate of Insurance. IF THE DELIVERY DATE CHANGES after a request has been submitted, a new request is required

Customer Email

The email address associated with this order

Customer Name

The name of the customer on this delivery order

Customer Order #

The order number can be located on communications about the order

Customer Mobile Phone #

Numeric value only

Customer ID #

Numeric value only

Delivery Address

The street address for the delivery

Delivery Address Line 2

Example: Apt #, Suite #

Delivery City

Delivery State

2-letter state abbreviation

Delivery Zip Code

Numeric value only

Certificate Holder Details:

Certificate Holder

Please obtain this information from the building. The Certificate Holder is typically the landlord or property management company requiring the Certificate of Insurance

Certificate Holder Address

Certificate Holder Address Line 2

Certificate Holder City

Certificate Holder State

2-letter state abbreviation

Certificate Holder Zip Code

Numeric value only

Additional Insured

Include any parties requesting to be listed as additional insured on the Certificate of Insurance

Building Contact Details:

Landlord or Building Email Address(s)

The completed Certificate of Insurance will be sent via email or fax. Please include ALL email addresses that need a copy, separated by a semicolon (Example: mybuilding@gmail.com; customer@yahoo.com)

Landlord or Building Phone #

Numeric value only

Landlord or Building Fax #

Numeric value only

Upload a file(s)

Upload other PDF documents required by the property (Example: hold harmless agreement)

Drag and drop or browse files to upload

Comments