Construction Pros

General Application

Please provide us your contact and mailing information

We realize you probably hate filling out forms. The good news here is that our forms are based upon your specific answers. In other words, if you are a veteran carpenter with 20 years of experience remodeling kitchens, it may take you far less time than perhaps a "start-up" roofer might. It seems to take the average contractor about 5 - 10 minutes to fill the basic information out. If you want a quote on your vehicles, go ahead and grab your VIN#s and drivers license before you start.

If we require you to fill out any other documents in the future, we will use your answers here to prefill any answers you may have already provided us.

Generally speaking, if you see a question that you think does not apply to your situation, leave the answer blank. Otherwise our system may interpret your "NA" answer as a "yes we test weapons at our facility". Blanks are OK! We will respond if there is an issue. Some of the questions enclosed are to either determine if you are eligible for certain discounts or if we need to ask you any other additional questions. Please let us know as much information as you can to help us achieve the best coverage at the lowest premium possible.

Company Name REQUIRED

DBA (if any)

Web Address

Physical Address 1 REQUIRED

Physical Address 2

Physical Address City

Physical Address State

Physical Address Zip Code

County

Business Phone Number REQURED

Federal Tax ID Number (FEIN)

Principal Contact Name REQUIRED

Principal Contact Phone Number

Principal Contact Mobile Phone Number

Principal Contact Email Address REQUIRED

What percentage of the time are you the GC, Sub, or a Construction Mananger?

If you never or VERY rarely perform a particular type of work, leave the answer completely blank, otherwise you will get asked a bunch of needless questions!

General Contractor

Subcontractor

Construction Manager

The total for the three categories above should equal 100%

What percentage of your work is the following:

If you never or VERY rarely perform a particular type of work, leave the answer completely blank, otherwise you will get asked a bunch of needless questions!

New Construction

Renovation

The total for both of the categories above should equal 100%

How many years has your company been in business?

If you are a start-up, thats perfectly OK. We write lots of start-up contractors. We just need to know this so we can ask you the right questions later on.

Years

Start date? mm/dd/yyyy

Check here if your business is less than 1 year old

How many total years of construction experience do you have?

Years

What is your mailling addreess?

Mailing Address 1

Mailing Address 2

Mailing Address City

Mailing Address State

Mailing Address Zip Code

County

While performing your duties as a construction mananger, do you retain the authority to hire and fire your subcontractors?

Yes

While performing your duties as a construction mananger, do your subcontractors typically sign a contract with you or the project owner?

Yes

How much compensation do you expect to receive as a construction manager in the next 12 months?

If the draw is going directly to you and you are paying the subcontractor yourself, then the the insurance companies assume your are a GC and not a Construction Manager. If that describes your typical situation simply type NA in this box.

In dollars of payroll

Although some of these questions may seem strange, the insurance companies definition of a Construction Manager is very different than what most contractors think it is. This can be to your benefit premium wise. That's why we ask!

What do you estimate your total gross receipts will be in the next 12 months?

Gross Receipts

What do you think your total payroll will be for the next 12 months?

We realize (in this economy) you are guessing. Give us your best estimate.

Total Payroll

How much of that total payroll is for administration and not actual field work?

By administration, we mean office staff and not the guys in the field. Insurance carriers try to exclude their payroll from any calculations because they do not represent the actual work you are performing in the field. You can include estimators provided they NEVER leave the office. Draftsman would count too.

Admin Payroll

Describe your typical work performed. Feel free to go into detail.

Description

Do you have any of the following?

If you do, and it is reasonable to do so, send a copy of each to myagent@constructionprosins.com. If you are looking to implement any of these in the near future, go to our site at www.comstructionprosins.com/DD and download a copy of one of our templates. This will save you a few hours of work at least!

Pre Employment Drug Testing

Employee Manual

Fleet Manual

Written Subcontractor Agreement

What limits would you like quoted?

$500,000 per occurence $1,000,000 general aggregate

$1,000,000 per occrence $2,000,000 general aggregate

Something higher

If you want limits higher than $1,000,000 per occerance, we will most likely need to quote you an Umbrella policy too. This is a policy that goes over your General Liability policy (like an umbrella) to provide limits higher than the underlying policy. We can get to that after we gather some information about your General Liability exposure first.

Does your work involve any of the following?

Underground excavation below 4 feet

Condominiums or Apartments

Work on the exterior of 4 story or taller buildings or any work above 40 feet above ground?

Tunneling

Work for, on, or near a railroad/CSX

Explosives (like C-4, dynamite, ANFO, NOT gasoline)

Frequent use of cranes (more than once a year)

Use of large quantities of toxic or volatile chemical

Work in foreign countries

EIFS or stucco work

Designing or engineering any aspect of a job that would typically require an architect or engineer to stamp your plans.

Storing materials that have already been purchased by your customer and stored for extended periods at your location.

Checkbox35

Checkbox36

If you checked any of the above items, please explain further here:

Explanation

Would you like a quote for General Liability?

What does General Liability cover again?

Yes

Would you like a quote for Work Comp?

What does Work Comp cover?

Yes

Would you like a quote for Commercial Auto?

Yes

Do you need a code compliance bond?

Yes

Do you have any large mobile equipment like bulldozers or excavators that you want to insure?

Please note that none of your tools or equipment are insured under your General Liability policy.

Yes

Do you want covereage for any of your smaller tools?

Please note that none of your tools or equipment are insured under your General Liability policy.

Yes

This is for your smaller tools such as hammers, wrenches, and pretty much anything under $1000 in value or less. You do not need a detailed inventory. All we need is simply a dollar amount you want them insured for. Anything over $1000 should be listed under the next section titled "Scheduled Tools". If your tools live in your trucks or in a job trailer, you probably need this covereage. Here is some more information on these coverages.

Do you have any larger tools worth over $1000 such as compresors, welders, or other items that you would like coverage for?

Please note that none of your tools or equipment are insured under your General Liability policy.

Yes

Would you like to insure your building and/or any of its contents?

Please note that your building and it's contents including your inventory and furniture are not insured under any other policy.

Yes

You indicated earlier that you wanted higher limits than $1,000,000 per occurence and $2,000,000 general aggregate. What limits would you like quoted?

$1,000,000

$4,000,000

$5,000,000

$10,000,000

Would you like a different amount quoted that is not listed?

Please indicated desired coverage limit

Do you have any materials that are left on the jobsite (before they are installed) that you wold like to insure against potential loss ro theft?

Yes

If you frequently leave materials on a jobsite before they are installed, particulary higher value materials such as light fixtures, AC compressors, or similar items, you may want to include this in your quote. Beware that sometimes the GC on a large project may require subs to carry this covereage acccordng to the contract.

How many certificates of insurance are you required to produce in a given year?

None

1 to 10

11 to 50

50 or more

What's a certificate?

If you can provide us a list of your certificate holders in an Excel format, you will be greatly appreciated! Please send the file to myagent@constructionprosins.com

Are you asked to provide any of the following to your owners or GC's?

Please note if you mostly perfrom work on commercial projects, then this may be extremely critical for you to comply with any contracts you curretly have or will sign. Follow this hyperlink if you have any questions as to what these items are.

Waiver of Subrogation

Per Project Aggregate Limits

Primary Non-Contributory Endorsement

Additional Insured with Completed Operations

You indicated earlier that you subcontract some of your work. We need to learn a little more about this exposure to make sure you are properly insured at the correct rate.

Do you obtain proof that your subcontractors carry insurance that has equal or greater limits than your own?

Yes

Do you ask your subcontractors to list you as an additional insured?

Yes

Do you obtain a wirtten contract with your subcontractors asking them to indemnify you and hold you harmless for their actions or work?

Yes

Have you had a lawyer review your subcontractor agreement in the last 3 years?

Yes

Please describe the type of work you typically subcontract

Description

Would you like us to obtain a pollution liability quote for you?

More about pollution coverage.

Yes

Esentially all other policies like your General Liability will exclude Pollution. You may think that since you are not carrying toxic sludge or nuclear weapons that this should not be an issue, right? Wrong! Insurance companies define a pollutant as follows:

�Any solid, liquid, gaseous or thermal irritant or contaminant, including smoke, vapor, soot, fumes, acids, alkalis, chemical, liquids, gases and waste. Waste includes materials to be recycled, reconditioned or reclaimed.�

In short, this means just about anything can be a pollutant. Things such as milk, concrete dust, orange juice, polyurethane overspray, and many other seemingly innocent items have been excluded by insurance carriers by being classified as a pollutant.

So do you need this coverage? We recommend ALL of our larger contracting clients purchase this coverage because #1) it�s usually cheap and #2) their General Liability policy, even if it covers some pollutants, is not adequate.

You indicated earlier that you perfrom mostly commercial work. If that is the case, be sure to answer the next questions carefully as these critical to meet your insurance needs correclty.

If you perform any work for Skanska, you may want to check out this page on our site if you have not already done so.

Please click Finish below to send your answers!

PLEASE CLICK THIS LINK FOR US TO RECEIVE YOUR ANSWERS!

DO YOU OR ANY OF THE OWNERS OF THIS BUSINESS, EITHER INDIVIDUALLY OR IN COMBINATION WITH OTHER OWNERS OF THIS BUSINESS, OWN MORE THAN 50% OF ANY OTHER BUSINESS, WHICH OPERATED AT ANY TIME DURING THE FIVE YEARS PRIOR TO THIS APPLICATION? OR DOES THIS BUSINESS OWN A MAJORITY INTEREST IN ANOTHER ENTITIY, WHICH IN TURN OWNS A MAJORITY INTEREST IN ANY ENTITY THAT OPERATED AT ANY TIME IN THE FIVE YEARS PRIOR TO THIS APPLICATION?

Yes

Do you plan on excluding any owners from work comp?

Yes

Since you had work comp with a prior company you owned, the insurance carrier will want to know if the prior policy and it's losses need to be considered with your current company. Please click on THIS LINK to fill out a document called an ERM 14. Here is the link for the instructions if you need them. Send that completed document to myagent@constructionprosins.com along with any others.

Please tell us who you are excluding:

Name

Type of work they perform

SS#

Ownership percentage

Name

Type of work they perform

SS#

Ownership percentage

Name

Type of work they perform

SS#

Ownership percentage

You can only exclude a maximum of 3 owners. Click here if you have any questions.

Other than Florida, what other states do you frequently work in?

Other States

Do you currently have an NCCI experience modifier ERM or "Mod"?

This is the number used to "experience rate" your premium based upon prior loss history. Typically the number ranges between 0.60 and 2.0. If you have been in business for less than 3 years or have been using a leasing company, you may not have one. Click here for more information.

If so, input that number here:

Do any of these apply to your current or future operations?

CHECK HERE IF YOU OWN, OPERATE OR LEASE AIRCRAFT/WATERCRAFT.

CHECK HERE IF PAST, PRESENT OR DISCONTINUED OPERATIONS INVOLVE(D) STORING, TREATING, DISCHARGING, APPLYING, DISPOSING, OR TRANSPORTING OF HAZARDOUS MATERIAL? (e.g. landfills, wastes, fuel tanks, etc)

CHECK HERE IF ANY WORKIS PERFORMED ON BARGES, VESSELS, DOCKS, BRIDGE OVER WATER.

CHECK HERE IF YOU ARE ENGAGED IN ANY OTHER TYPE OF BUSINESS.

CHECK HERE IF ANY WORK IS PERFORMED UNDERGROUND OR ABOVE 15 FEET.

CHECK HERE IF ANY GROUP TRANSPORTATION PROVIDED.

CHECK HERE IF ANY EMPLOYEES UNDER 16 OR OVER 60 YEARS OF AGE ARE USED.

CHECK HERE IF ANY PART TIME OR SEASONAL EMPLOYEES ARE USED.

CHECK HERE IF YOU HAVE ANY VOLUNTEER OR DONATED LABOR.

CHECK HERE IF YOU HAVE ANY EMPLOYEES WITH PHYSICAL HANDICAPS.

CHECK HERE IF EMPLOYEES TRAVEL OUT OF STATE.

CHECK HER IF YOU SPONSOR ATHLETIC TEAMS.

CHECK HERE IF PHYSICALS REQUIRED AFTER OFFERS OF EMPLOYMENT ARE MADE.

CHECK HERE IF ANY PRIOR COVERAGE HAS BEEN DECLINED/CANCELLED/NON-RENEWED (Last 3 years)?

CHECK HERE IF EMPLOYEE HEALTH PLANS ARE PROVIDED.

CHECK HERE IF THERE IS A LABOR INTERCHANGE WITH ANY OTHER BUSINESS/SUBSIDIARY.

CHECK HERE IF YOU LEASE EMPLOYEES TO OR FROM OTHER EMPLOYERS.

CHECK HERE IF ANY EMPLOYEES PREDOMINANTLY WORK AT HOME.

CHECK HERE IF YOU HAVE ANY CURRENT OR ANTICIPATED DEBT FOR UNPAID PREMIUMS OWED TO ANY PREVIOUS WORKERS' COMPENSATION PROVIDER.

Explain briefly any affirmative answer you indicated above

Requested Limit

How much would you like your tools insured for?

What deductible would you prefer?

$250

$500

$1000

Please email an Excel spreadsheet to myagent@constructionprosins.com that has a list of the equipment you would like to insure. Please include serial numbers and descriptions with this file, when available.

What deductible would you prefer?

$250

$500

$1000

What deductible would you prefer?

$250

$500

$1000

What is the maximum value of uninstalled materials that could be lost or stolen from the job site at any one time?

How much would you like your tools insured for?

What deductible would you prefer?

$250

$500

$1000

How many "business use" licensed vehicles do you have?

1-2

3 or more

How many licensed drivers operate company vehicles?

1-2

3 or more

If you have more than 2 vehicles, most of our clients find it easier to email us a spreadsheet. To do this, simply include the Make, Model, Year, VIN#. If you have the GVW and/or an estimated cost when new, that is even better. Please note that if any vehicles have unique equipment such as drilling rigs or cherry pickers and include their estimated value as well. Send the spreadsheet to myagent@constructionprosins.com. Please indicate if any of these vehicles have a lien or are leased and to whom.

If you have more than 2 drivers, most of our clients find it easier to email us a spreadsheet. To do this, simply include the drivers FULL NAME and DL#. If you have state the license was issued in, and birthdate too, that is ideal. Send this spreadsheet to myagent@constructionprosins.com.

Tell us about your vehicle(s):

Vehicle #1 Make

Vehicle #1 Model

Vehicle #1 Model Year

Vehicle #1 VIN#

Vehicle #1 GVW

Vehicle #1 Value when new

Vehicle #2 Make

Vehicle #2 Model

Vehicle #2 Model Year

Vehicle #2 VIN#

Vehicle #2 GVW

Vehicle #2 Value when new

Tell us about your driver(s)

Driver #1 First Name

Driver #1 Last Name

Driver #1 Birthdate

Driver #1 Drivers License #

Married

Single

Divorced

Has this driver #1 had any accidents or citations in the last three year?

Check here if "yes"

If "yes" please give a brief explanation of what and when

Tell us about your driver(s)

Driver #2 First Name

Driver #2 Last Name

Driver #2 Birthdate

Driver #2 Drivers License #

Married

Single

Divorced

Has this driver #2 had any accidents or citations in the last three year?

Check here if "yes"

If "yes" please give a brief explanation of what and when

CHECK THE BOX BELOW IF THE CONDITION DESCRIBES YOUR CURRENT OR FUTURE CONDITIONS.

CHECK HERE IF WITH THE EXCEPTION OF ENCUMBRANCES, ANY VEHICLES ARE NOT SOLELY OWNED BY AND REGISTERED TO YOU.

CHECK HERE IS IF OVER 50% OF YOUR EMPLOYEES USE THEIR AUTOS IN YOUR BUSINESS.

CHECK HERE IF YOU HAVE A SPECIFIC MAINTENANCE PROGRAM IN OPERATION.

CHECK HERE IF YOU LEASE ANY VEHICLES TO OTHERS.

CHECK HERE IF ANY ICC, PUC OR OTHER FILINGS REQUIRED.

CHECK HERE IF ANY OPERATIONS INVOLVE TRANSPORTING HAZARDOUS MATERIAL.

CHECK HERE IF YOU ENTER INTO ANY HOLD HARMLESS AGREEMENTS.

CHECK HERE IF ANY VEHICLES USED BY FAMILY MEMBERS.

CHECK HERE IF YOU OBTAIN MVR RECORDS ON YOUR APPLICANTS.

CHECK HERE IF YOU HAVE A SPECIFIC DRIVER RECRUITING METHOD.

CHECK HERE IF ANY OF YOUR DRIVERS ARE NOT COVERED BY WORKERS COMPENSATION.

CHECK HERE IF YOU HAVE ANY VEHICLES THAT YOU OWN BUT ARE NOT SCHEDULED ON THIS APPLICATION.

CHECK HERE IF CONSTRUCTION PROS, ANOTHER AGENT, OR INSURANCE COMMPANY INSPECTED YOUR VEHICLES IN THE LAST 2 YEARS.

CHECK HERE IF YOU OR YOUR SPOUSE STILL MAINTAIN A PESONAL AUTO POLICY.

Of all the policies you purchase, this one will probably be where you have the most, if any claims. We recommend to all of our clients to purchase high limits. If you purchase the state minimum of $10,000/$20,000 you are asking for trouble, unless you are convinced the most expensive car you could hit is a Yugo.

The fact is this: Attorneys make their living suing contractors just like you for idiotic auto claims. Once the guy who was tapped lightly on the bumper calls �1 800 ASK IDIOT� and his new "attorney" finds out that the truck who hit him had your business�s name on the side, you can plan on the first demand from his attorney being well over $100,000. If you drive a triple axel dump truck filled with asphalt or something else big and heavy, then you should start with setting your limits at $1,000,000 minimum. This is just our advice. If you still want lower limits than $100,000, we may not be the right agency for your company.

What limits would you like to request?

If you require limits higher than $1,000,000 be sure to request an umbrella quote as this is the most cost effective way to obtain these higher coverage limits.

$100,000/$300,000

$500,000 Combined Single Limit

$1,000,000 Combined Single Limit

What size deductible were you looking to have?

$250

$500

$1000

Check here if you want Uninsured Motorist covereage

Check here if you want towing coverage on any of your vehicles

Check here if you wish "Morgan & Morgan" would just go away...

How far do your vehicles usually travel away from your shop most of the time?

Would you like us to quote you Pollution Liability coverage?

Check here if "yes"

Almost all Commercial Auto policies exclude Pollution. You may think that since you are not carrying toxic sludge or nuclear weapons that this should not be an issue, right? Wrong! Insurance companies define a pollutant as follows:

So do you need this coverage? We recommend ALL of our larger contracting clients purchase this coverage because #1) it�s usually cheap and #2) their Business Auto policy, even if it covers some pollutants, is not adequate.

For Performance, Bid, Payment or Maintenance Bonds, go here.

The first question is obviosuly "how much does this thing cost"? The short answer about $100 for a one year bond and $170 for a two year term. This is for a typical $5000 code compliance bond in Hillsborough County. If you need a Performance or Bid Bond, please go to the "Bond" page on our website for more information.

What size bond do you need?

$5,000

$10,000

Some other amount

Have you been declined or cancelled by any other Surety in the past 5 years?

Having had a bond cancelled does not mean you are sunk. Due to the recent economy, many contractors are dealing with surety issues. It GREATLY helps your case to let us know up front if you have had any past issues. Trust us here. Grandpa was right - honesty IS the best policy!

Check here if "yes"

Explain why

What is the aproximate working capital or net worth of your business?

If you are a larger contractor and have your current "working capital" report, WIP and balance sheet handy, send that to myagent@constructionprosins.com. Otherwise just indicate a rough estimate here.

Amount

Some cities and counties are very strict about having the bond EXACTLY match the wording on your contractor license. Hillsborough County and Jacksonville are two examples. To insure that your bond is issued correctly the first time, please send a copy of your license to myagent@constructionprosins.com.

Version 3.0 Updated 5/4/2012

Please do not feel like every answer must be the exact mileage, weight or value. For example: If your trucks average 52 miles round trip each day and you type down 50 on this application, you should be perfectly OK. If you indicate that your payroll is only $50,000 a year when in fact it is closer to $5,000,000 - let�s just say you will not be getting a Christmas card from our office this year. The important fact here is do not omit anything that is "material" to our assessing your risk as a potential insured!

We try to find our clients discounts and special programs when they are available. Tell us any and everything that you may think could help us provide you with a competitive rate. For example anybody performing Army Corp projects receive all kinds of certificates that say "job well done" or "no lost days". Send those in with your application to our office at myagent@constructionprosins.com. If you were an Eagle Scout, we want to know about it! These facts do not always make a difference, but some times they do. Help us make you look good to the insurance companies. In the end, that helps all of us get the job done.

The lawyers want us to make it very clear that YOU CAN NOT ACQUIRE INSURANCE BY ONLY ANSWERING THE FOLLOWING QUESTIONS! You cannot change, bind, or modify existing coverage�s either. These questions are only a tool that enables us to assess your risk as a potential insured, and should not be viewed as a commitment by our agency or our carriers to provide coverage.

Thank you for reading this. We hope you become a client soon!

Our lawyers want us to make sure you read the above information. Did you?

Check here if you did.

Do you own or rent your location?

We own it

We rent it

Is your mailing address the same as your physical address?

yes

What type of business entity are you?

Sole Proprietor

LLC

Subchapter S

C Corp

Partnership

Joint Venture

What licenses do you currently hold?

Please list any licenses you curently have active

What type of work do you usually perform?

Don't panic! You can still perfrom other kinds of work. We are simply just trying to figure out what other questions we need to ask you at this point.

If your work is a mix of the items on the left that is OK, we just need to know what your principal focus is, or will be.

Handyman

Residential Construction (homes, townhouses, condos, apartment)

Commercial (office buildings, hospitals, retail, etc.)

Industrial (factories, refineries, chemical plants, etc.)

How much of the total payroll is the owners? Exclude any dividends etc. We are only looking for the actual "salary".

If you have several owners, please include ALL of the salaries together.

Owners Salary

How many owners (getting paid)?

Is the owners salary part of the administration payroll?

Yes

How much work do you think you will subcontract in the next 12 months?

Subcontracted work total

Check the following optional coverages you would like us to include:

Wind/Hurricanes

Business Interuption (Lost Income)

Flood

Equipment Breakdown (Boiler and Machinery)

Sinkhole

You indicated earlier that you rent your building. You can still obtain property coverage on your contents. Would you like to obtain coverage for your contents only?

Yes

Actually I own the building through another company that I own, so yes, I would like to get coverage for it.

Tell us about the company you have that owns the building

Name your building is owned under

Address 1 for this entity

Address 2 for this entitiy

City

State

Zip

It sounds like you are just getting started. Here is some good news for you: We have TONS of resources for our clients that are just starting out. Almost all of this is free of charge. Most of this you will either need now or in the near future like sample subcontractor agreements, indemnification wording, templates for fall protection, safety manuals, and quite a bit more. Click here to see our form library. Here you can find safety manuals. Working on your subcontractor agreement? Try here. Ask and ye shall receive!

Although you may select the limits of insurance you did, you also indicated that you will be doing mostly commercial work. If that is the case, you may want to go back and elect the higher limts of $1,000,000/$2,000,000. The reason why is most commercial GC's and project owners will automatically ask for these limits on their contracts. You will end up having to increase them later on, which may cost a little more, but is also a pain to do. The good news is that it changes the premium very little to have increased limits.

What would you like to do?

Lets go with the higher limits

Thanks but I'm OK

PLEASE CHECK THE BOX BELOW IF ANY OF THE STATEMENTS ARE TRUE

CHECK HERE IF YOUR ARE A SUBSIDIARY OF ANOTHER ENTITY.

CHECK HERE IF YOU HAVE ANY SUBSIDIARIES.

CHECK HERE IF YOU HAVE A FORMAL SAFETY PROGRAM IN OPERATION.

CHECK HERE IF YOU HAVE ANY EXPOSURE TO FLAMMABLES, EXPLOSIVES, CHEMICALS. (please exclude incidental chemicals such as gasoline, paint thinner, etc.)

CHECK HERE IF YOU HAVE ANY OTHER INSURANCE WITH OUR AGENCY OR BEING SUBMITTED.

CHECK HERE IF YOU HAD ANY POLICY OR COVERAGE DECLINED, CANCELLED OR NON-RENEWED DURING THE PRIOR 3 YEARS.

CHECK HERE IF YOU HAD ANY PAST LOSSES OR CLAIMS RELATING TO SEXUAL ABUSE OR MOLESTATION ALLEGATIONS, DISCRIMINATION OR NEGLIGENT HIRING.

CHECK HERE IF AT ANY TIME DURING THE LAST FIVE YEARS IF YOU HAVE BEEN INDICTED FOR OR CONVICTED OF ANY DEGREE OF THE CRIME OF FRAUD, BRIBERY, ARSON OR ANY OTHER ARSON-RELATED CRIME IN CONNECTION WITH THIS OR ANY OTHER PROPERTY?

CHECK HERE IF YOU HAVE ANY UNCORRECTED FIRE CODE VIOLATIONS.

CHECK HERE IF YOU HAVE HAD ANY BANKRUPTCIES, TAX OR CREDIT LIENS AGAINST YOU IN THE PAST 5 YEARS.

CHECK HERE IF YOUR BUSINESS BEEN PLACED IN A TRUST.

CHECK HERE IF HAVE ANY FOREIGN OPERATIONS, YOU DISTRIBUTE FOREIGN PRODUCTS IN USA, OR YOUR PRODUCTS ARE SOLD/DISTRIBUTED IN FOREIGN COUNTRIES.

Please briefly explain any of the boxes you checked above

Which (if any) of the follwing classifications best describes the work you do? You can check more than one. If you find yourself checking more than 5, you probabaly only need to let us know what constitutes a MAJORITY of your work. A little bit of incedental demo here and there is not a big deal.

You may pick multiple categories however, please focus on the primary categories you perform most of your work in.

Airport Work

Alarm Systems

Bridge Work

Carpentry

General Contracor

Project Manager

Powerline Installation

Electrical Work

Elevator Installation and Repair

Underground Utilities

Handyman

Hazzerdous Materials

Insulation Work

Jetty or Breakwater Construction

Metal Door Installation

Millwork

Sheetmetal Work

Metal Work - Erection

Painting - Interior

Painting - Exterior

Site work - Excavation

Street and Road work/Paving

Masonry

Concrete Work

Roofing

Plumbing

HVAC

Demolition

Environmental Remediation

Swimming Pools

Renovation (Including Trash-Outs)

Other

Tell us about your building

What year was it built?

How many square feet is it?

Amount you would like it insured for?

When was the roof last replaced?

What are the walls made primarily out of?

Masonry/Concrete

Metal

Wood

Tell us about your contents in the building

What do you estimate your contents to be worth?

If you have any "permanently mounted" equipment, what would you estimate the value to be?

Are you including any inventory in the above values?

Yes

Do you have any seasonal fluctuations in your inventory?

Yes

Does the building have a fire sprinkler system?

Yes

Does the building have an alarm system?

Yes

Who installed/services it?

Are the fire extinguishers regularly inspected?

Yes

What is the roof material made out of?

Metal

Asphalt Shingles and Tar Paper

Built-Up Material

How Many Stories?

Any lower levels?

When was the plumbing last updated?

In order to insure the contents, we will still need to know a little about the building - since the contents are inside of it.

Are you a current client of Construction Pros?

Yes

First, Thank you for your business! Please let us briefly know who you are so that we can retrieve your information.

Your company name (REQUIRED)

Your name (REQUIRED)

Your email address (REQUIRED)

What percentage of your work is the following?

FLAT ROOFS

PITCH ROOFS

ASPHALT SHINGLE

FIBERGLASS

WOOD

SLATE

METAL

SINGLE PLY

TILE

POLYURETHANE FOAM

HOT TAR

TORCH DOWN

OTHER - DESCRIBE

Operations

Describe any other operations or work done other than roofing (e.g., waterproofing, siding, asbestos removal, rain gutters, carpentry, etc:

Describe what safety precautions are in place if hot tar, torch down or other hot processes are used?

What is the maximum height of the buildings you work on?

If over 3 stories, do you use any of the following systems:

Guardrail system with toes boards

Saftey net

Personal fall arrest system

Precautions

How do you protect the general public from potential injury?

How are materials lifted to the roof?

How are openings in the roof protected over night?

What precautions do you take when a rainstorm is imminent?

Please check the box if the answer is yes:

Does a foreman or contractor inspect all jobs upon completion?

Have you ever or do you currently perform work in AZ, CA, CO, NV, NY, OR, UT or WA?

Have you ever used, sold, installed or removed asbestos?

Are Cranes used?

Are barriers in place to protect the public?

If owned, is equipment under a regular maintenance schedule?

Are employees properly trained and certified?

Do you have a �fire watch� program to assure there are no �hot spots� after completion of a job?

Do you comply with all state & OSHA regulations?

It is a "best practice" to have a written subcontractor agreement with all of your subcontractors. If you do not have one already, please look at our contractual liability section for documents that you may use as a template to create your own.

If you already have a subcontractor agreement, please email a copy of this document to myagent@constructionprosins.com.

You indicated earlier that you do a bit of roofing. This will involve a few more questions than the average handyman. If you indicated roofing because you may do a repair here or there, then I would skip these questions if I were you. If however you are a ROOFER - then indicated below and lets get these done. The good news here is that we will NOT be sending you one of those other forms to fill out later! We will use your answers here to populate those forms already. We may need a signature, but this will save you a BUNCH of time down the road, so answers these as best you can now.

So what do you want to do?

Yeah. I am a Roofer. Lets get these questions over with.

No way! I only did a patch here and there for a friend. I am not really a Roofer.

Session Summary

These questions ARE NOT an offer to provide insurance to you or any company you may work with. They are ONLY a means of collecting information about your company. Any information collected may be used to underwrite your company. If you would like an actual quote for insurance, please contact our office directly via telephone or email to let us know your desire to obtain coverage from us. Any existing coverage you may have or lack thereof cannot be changed bound or modified via this system. Construction Pros Insurance LLC, its employees, officers, and directors cannot be held liable for any information we receive or fail to receive via this system. Please contact our office at info@constructionprosins.com if you have any questions about this disclaimer, or any other insurance related question.