Contractors Liability Insurance Quote

Get your Contractors Liability Insurance Quote – Contractor’s Insurance can be complicated. This quick quote form allows us to rate your coverage request simply and easily to assist you in obtaining insurance for your contracting business.

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Step 1 of 6

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Name*

First Last

Full Legal Business Name*

Business Entity is*

Do you have and DBAs or Trade Names?*

What DBAs or Trade Names do you use?*

Phone Number*

Email*

Alt Phone Number (cell, home)

Mailing Address*

Street Address Address Line 2 City State ZIP Code

Website

Date That Your Business Started*

MM slash DD slash YYYY

Please Describe the Nature of Your Business in Detail*

Experience & Basic Rating Information

Is the physical address of your business different form your mailing address?*

Yes

Address of your Operations*

Please enter the physical address of your operation. Do not enter a PO Box unless you work at the post office.

Street Address Address Line 2 City State ZIP Code

How many owners does the company have?*

Number of Full Time Field Employees*

Not Included the Owners. Enter 0 if zero

Number of Part Time Field Employees*

Not Included the Owners. Enter 0 if zero

Tasks Your Employees Perform

Total percentages must equal 100%

Primary Class*

% of Total Work*

Please enter a number from 0 to 100.

Add a 2nd labor class?*

Yes

Secondary Class*

% of Total Work*

Please enter a number from 0 to 100.

Add a 3rd labor class?*

Yes

3rd Class*

% of Total Work*

Please enter a number from 0 to 100.

Add a 4th labor class?*

Yes

4th Class*

% of Total Work*

Please enter a number from 0 to 100.

Add a 5th labor class?*

Yes

5th Class*

% of Total Work*

Please enter a number from 0 to 100.

How do you hire subcontractors?*

We Do Not Use Subs!

Usually Use Same Ones

Usually Put it Out to Bid

Do you ever use Day Laborers?*

Day Laborers are independent, individual, uninsured, helpers, that are not subcontracted workers or pay-rolled employees.

Yes

Provide a detailed description of how day laborers are used and how often.*

What is your total annual cost of Day Laborers?*

Subcontractors

Would you like coverage for Injuries to Your Subcontractors?*

Yes

Primary Subcontractor Class*

% of Total Work*

Please enter a number from 0 to 100.

Add a 2nd Subcontractor Class?*

Yes

Secondary Subcontractor Class*

% of Total Work*

Please enter a number from 0 to 100.

Add a 3rd Subcontractor Class?*

Yes

3rd Subcontractor Class*

% of Total Work*

Please enter a number from 0 to 100.

Add a 4th Subcontractor Class?*

Yes

4th Subcontractor Class*

% of Total Work*

Please enter a number from 0 to 100.

Add a 5th Subcontractor Class?*

Yes

5th Subcontractor Class*

% of Total Work*

Please enter a number from 0 to 100.

Do you require subcontractors to carry general liability insurance?*

Yes

Do you require subcontractors to name you as additional insured on their General Liability Policy?*

Yes

Do you have a standard formal written contract with all subcontractors that includes a Hold Harmless and Indemnification clause?*

Yes

Do you require subcontractors to carry Worker’s Compensation?*

Yes

Operational

How are materials lifted to the roof?

Check all that apply

Ladder

Hoist

Pulley

Crane

Boom

Supplier Lifts Them

Do you have a written safety program in place?*

Yes

Financial & Income Information

Do not enter $0 for payroll or revenue

Total Annual Payroll for your Employees - Not Including Owners*

Total Annual Anticipated Gross Revenue*

Total Annual Cost of Sub-Contractors*

Operations & Experience Information

What percent of your work is performed in New York City*

How many Years of Experience do you have?:*

Are You Licensed?*

If so, what kind of license(s) do you hold?*

Percent of work done INSIDE*

Percent of work done OUTSIDE*

% of Work Done as a General Contractor or GC*

A GC is one that subcontracts work.

% of Work Done as a Contractor*

A Contractors is one that is hired directly by the client

% of Work Done as a Subcontractor*

A Subcontractor is one that is hired directly by the GC

Percent of Work Done is RESIDENTIAL*

Percent of Work Done is COMMERCIAL*

% of Work - New Construction*

% of Work - Remodeling*

% of Work - Demolition*

Have you worked as a General Contractor Building Residential Homes, Condos, or Townhouses in the last 10 years*

Yes

Which of the following equipment do you use*

Select all that apply

None

Hand Tools

Booms

Ladders under 2 stories

Ladders over 3 stories

Cherry Pickers/Bucket Lifts

Cranes

Hoists

Forklifts

Kettles

Pulleys

Scaffolding

Tractors

Bull Dozers

Which equipment from above is rented as opposed to owned?*

Underwriting & Procedural Information

List major Projects completed within the last Three Years. Include work in progress and planned work.

(List protect names, date, description, location & revenue)

List

Enter NONE if there have been none in the last 3 years.

Project Type

Start Date

City & State

Revenue

Completed?

Is any work done involving systems that provide:*

None

Process Piping

Dams / Levees

Medical and/or Life Support Systems

Underpinning

Maximum number of FEET above grade work is performed from?:*

Any work performed below grade?*

Yes

If so what is the Maximum Depth*

What is the % of your total work below grade?*

Do you use scaffolding for your operations?*

Yes

Is it owned or rented?*

Are other contractors at the site allowed to use it?*

Yes

Has any Prior work included Exterior Insulation Finish Systems (EIFS)?*

Yes

If so please explain*

Have you ever built or intend to build on hillsides, slopes, landfills/dumps or in subsidence areas?*

Yes

If so please explain*

Do you or any of your employees hold Real Estate licenses?*

Yes

If so, how much Professional Liability Coverage is provided?*

Any other operations outside the realm of "Contracting"?*

Yes

If so please explain*

Any mobile equipment leased from others?*

Yes

If so please explain*

Do you own any Undeveloped Vacant Land, held only for development or investment?*

Yes

If so please explain*

Do you do any work on a ladder over 2 stories?*

Yes

If so how many feet high?*

Loss Information

Any losses or claims in the last 5 Years?*

Yes

List*

Loss Date

$ Loss Amount

Description of Loss

Current Insurance Information

Are you currently insured*

What is the name of your current insurance carrier?*

Insurance Company, not your broker's name.

DateCurrent insurance expiration date*

MM slash DD slash YYYY

Current annual insurance premium*

How long have you been continuously insured?*

Coverage Information

Liability Coverage Requested*

This provides coverage for bodily injury and property damage

$100,000

$200,000

$300,000

$500,000

$1,000,000

$2,000,000

Liability Deductible Requested*

Umbrella/Excess Liability Coverage*

Do you currently have Workers Comp coverage?*

Yes

Do you currently have Disability Insurance coverage?*

Yes

Finance Information

Ever filed Bankruptcy or Reorganization*

Yes

Has coverage been Declined, canceled or non-renewed in last 5 years

Yes

If so, why?*

Final Details

How soon do you need this quote*

What date do you need this QUOTE by?*

MM slash DD slash YYYY

What date do you need this COVERAGE by?*

MM slash DD slash YYYY

How did you hear about us?

If you were referred, who can we thank with a nice gift?

What other coverages are you interested in?*

None

Workers Comp

Disability

Group Health

Employment Practices Liability

Business Property / Tools

Business Income Coverage

What is your total annual payroll?*

What is your company's Federal Tax ID #

How many male employees do you have?*

How many female employees do you have?*

Business Property*

This provides coverage for your possessions your business owns. (desks, chairs, tables, books...)

Please enter a number from 0 to 10000000.

Property Deductible

What deductible would you prefer for the property coverage? Higher deductibles have lower insurance costs.

Business Income Coverage Requested*

This provides monetary coverage in the event your business is closed because of a covered loss (fire, storm, smoke damage)

Please enter a number from 0 to 10000000.

Do you have any specific insurance requirements you need to satisfy?*

I'll paste them below

I'll upload them

I'll paste & upload them

Paste your insurance requirements here.*

Upload your insurance requirements here.*

Drop files here or

Accepted file types: jpg, pdf, doc, docx, Max. file size: 10 MB, Max. files: 5.

Other things I want to tell you that you didn't ask. Additional comments, concerns, circumstances, or coverages you have/want.

Attachments

Please feel free to attach any files that might be useful in rating your coverages... Prior or current policies, insurance requirements, loss runs, claims, photos of puppies, pictures your kids drew in kindergarten, your favorite car, some recipe from Great Housekeeping Magazine ...

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Accepted file types: jpg, gif, png, pdf, tif, Max. file size: 12 MB, Max. files: 10.

Comments

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