| * = Required Information |
| This is not an instant quote website; our prices are too low to list online. Please fill out the quote form to obtain a Contractor Commercial insurance quote, and an insurance specialist will contact you shortly. Please understand this is not an application for insurance. An application will be sent to you if coverage is desired. |
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Proper Protection Fact Finding Questions |
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Contact Information |
| What else must I do to earn your business? |
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| Contact Name |
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| Business Name |
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| Address |
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| City |
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| State |
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| Zip Code |
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| Business Phone Number |
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| Primary Phone Number To Reach You |
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| Fax |
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| Email * |
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| Contact Me During? |
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Insurance Information |
| Current Insurance Company |
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| Current Policy Expiry |
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| Current Amount Coverage |
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| Liability Limit |
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| Number of Years Insured |
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| Losses and Claims for the Last 5 years |
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| If yes, what is the date, amount paid and description of each loss or claim? |
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Business Information |
| Number of Owners |
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| Number of Employees |
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| Payroll of Owners |
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| Payroll of Employees |
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| Rent or Own Office |
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| Annual Gross Receipts |
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| Total Annual Sub Costs |
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| Classification |
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| Contractors License Number |
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| License Type |
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| Years Operated Under Current Name |
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| Other Business Names |
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| Construction or Remodeling: |
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| Do you construct footings or foundations which may support dwellings or other structures? |
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| Do you construct slab or monolithic floors? |
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| Do you construct piers or underpinning which may support dwellings or other structures? |
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| Do you construct retaining walls which may support dwellings or other structures? |
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| Do you construct fireplaces or chimneys? |
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| What is the percentage of work done as a General Contractor? |
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| What is the percentage of work done as a Sub-Contractor? |
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| What is the percentage of work done on Residential? |
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| What is the percentage of work done on Commercial? |
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| What is the percentage of work done for Remodeling? |
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| What is the percentage of work done for Renovation? |
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| What is the percentage of work done for Repair or Maintenance? |
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| Any Additional Information |
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