Request for Self-Insurance Letters

This self-insurance request form is provided for the use of District government agencies ONLY.

The Government of the District of Columbia operates as a self-insured entity.  When a DC Agency requires proof of insurance (evidence of self-insurance), the DC Office of Risk Management (ORM) will review and consider all requests for such proof.  Please understand that all requests for proof of insurance letter shall be requested at least ten (10) days prior to its due date.

Please complete the following information for the Office of Risk Management to prepare the letter of self-insurance.

If you have any questions about the process of requesting self-insurance letters, please email [email protected].

Do not request a self-insurance letter by email or fax.

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