General Contractor/Artisan Contractor Quote

Fill out the following form as completely as possible. Once you have completed the form, click the Submit button to send your information. Your request will be handled promptly.

First Name *

Last Name *

Company Name (include entity type) *

Mailing Address *

City *

State *

ZIP / Postal Code *

Physical Location (if different)

Phone Number *

E-Mail Address *

Time in Business *

Years' Experience *

Lines of Coverage to Quote

General Liability
Property
Workers Comp
Business Auto
Inland Marine
Umbrella
Other

Radius of operations from main location *

States worked in *

Payroll of owners, officers, and partners active at job sites or performing supervisory duties *

Payroll of employees other than owners, officers, partners, and clerical *

Cost of leased, temporary, staffing service, casual labor (if not included above) *

Total Payroll *

Do you employ any licensed architects, surveyors, engineers, Real Estate agents or brokers? *

Do you have any prior or planned jobs covered under "wrap up" or OCP policies? *

Describe your 3 largest projects currently underway or planned for the next year (include start/end date, value, and brief description) *

Describe your 4 largest projects over the past five years (include year completed, value, and brief description) *

Have you had any losses over the last 5 years? *

SUBCONTRACTORS

Do you obtain Cert. of Insurance for GL and WC from all subcontractors? *

What are the minimum GL limits you require?

Are written contracts obtained from all subs? *

Do you normally use the same subcontractors? *

What percentage of work do you sub out? *

What percentage of subcontractors utilized are insured?

Submission Validation

Required

Important Notice
Any submissions or payments made via this website do not constitute a binding agreement to your policy or coverages. Changes and payments to policies are not effective or binding until you, or any party involved, receive official notice from either your insurance agent, or your insurance company. If you have any questions, please feel free to contact us.

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