December 9, 2023

Contractors Liability Quote

Contractors Liability Quote

Name
First Last
Address
Street Address City State / Province / Region ZIP / Postal Code
DBA
Phone (XXX) XXX-XXXX
Email
Proposed Effective Date (MM/DD/YYYY)
General Liability Rating Criteria
Deductible
Number of Owners - Active in Field
Number of Full Time Employees / Payroll
Number of Part Time Employees / Payroll
Classification Type 1
Add Classification Type 2 ?
Classification Type 2
Add Classification Type 3 ?
Classification Type 3
Add Classification Type 4?
Classification Type 4
Subcontractor Costs
Gross Receipts (Annual Amount)
Applicants Business Experience / Insurance History
Number of losses/ Claims in last Five Years
Date When Loss/ Claim 1 Occurred
Amount of loss 1
Describe Loss 1
Date When Loss/ Claim 2 Occurred
Amount of loss 2
Describe Loss 2
Optional General Liability Coverages
- Up to 25% Credit - No work on New Residential Structures prior to Occupancy
- Per Project Aggregate
- Employee Benefits Liability
- Remove PRIOR COMPLETED OR ABANDONED WORK EXCLUSION
- Scheduled Additional Insured Endorsement (CG2010 11/85 equivalent)
- Pesticide or Herbicide Applicator Coverage
- Remove Employer's Liability Exclusion
- Faulty Workmanship Coverage (Contractors Errors and Omissions)