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Contractors
Complete the following questionaire.
* - Denotes Required Field
*Named Insured
*FEIN#
*BUSINESS IS
Corporation
Partnership
Joint Venture
Individual
LLC
*Detailed description of Insureds operations
a. Separately list all Named Insureds and description of all operations
b.Is or has insured been involved in any joint ventures or partnerships not described in a.
Yes
No
If yes, explain
c.Number of years in business
If account has website, list it here, otherwise type no
Does the account have marketing material?
Yes
No
If yes, did we secure it?
Yes
No
*Percentage of Operation as:
General Contractor:
%
Sub-contractor:
%
Owner/Builder:
%
Does the insured perform contracts that require bonding?
Yes
No
If yes, who is the bond carrier and what is their bond line?
*Do you at this time, or have you ever worked on residential construction (i.e.) single family homes, condos, apartments, or town homes?
Yes
No
If yes, please explain
*Describe the types of projects in which the Insured specializes
Describe any other projects, which the Insured has performed in the past 5 years.
*Does the Insured do any
exterior
work over two stories in height from grade?
Yes
No
If Yes: Maximum stories
Percentage of exterior work
*Does the Insured do any work below grade?
Yes
No
If Yes: Maximum depth
Percentage of total work
*Does the insured do any
interior
work over 2 stories in height from grade
Yes
No
If yes: How are building materials transported to upper floors?
Does the Insured have any operations other than contracting? If yes, explain below
*2007 to 2008 Estimated Annual Direct Payroll by Trade:
*Sub-contract Costs:
*Gross Receipts:
*Prior Years:
Direct Payroll:
$
Gross Receipts:
$
Indicate the percentage of construction work performed by the Insured:
New Construction:
%
Remodeling:
%
Commercial:
%
Residential:
%
Inside Bldg:
%
Outside Bldg:
%
Other(describe):
%
*List each state that the insured anticipants working in over the next year and % of receipts
*Is there a general contract between Insured and project owner:
Yes
No
If no, provide explanation:
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