Are you insuring a company or a person

Is the applicant's physical address the same as their mailing address?

the applicant's "doing business as" name

This is the name under which the company is doing business, if different

Website

Email *

Phone *

NAICS code

This is the North American Industry Classification System (NAICS) 6-digit industry code assigned to the business activity

SIC code

This is the Standard Industry Classification code assigned to the business activity. This is the code which represents the nature of the business which is contained in the Standard Industrial Classification Manual published by the Federal Office of Management and Budget.

How many full time employees does the applicant have?

How many part time employees does the applicant have?

What is the date that the business started?

These questions are about the applicant

Legal entity type

FEIN or social security number

Specify the applicant's primary industry

What is the nature of the company's business?

Please specify the nature of the company's business

Please describe the company's primary operations

List the states in which the applicant operates

List the applicant's annual income from last year

List the applicant's estimated current annual income

Please list all of the applicant's premises

Applicant's premises address

Applicant's premises building #

Applicant's premises property covered

Applicant's premises building description

Applicant's premises year built

Applicant's premises construction type

Applicant's premises total building area (sqft)

Applicant's premises city limits

Applicant's premises interest

Applicant's premises # FT employees

Applicant's premises # PT employees

Applicant's premises annual revenues

Applicant's premises operations description

Applicant's premises occupied area

Applicant's premises open to public area

Applicant's premises year of heating or air conditioning updates

Applicant's premises roof type

Applicant's premises burglar alarm logging

Applicant's premises fire protection

Applicant's premises % Sprinkler coverage

Applicant's premises additional interest - type

Applicant's premises additional interest - certificate required

Applicant's premises structure type

Applicant's premises roof year

Is the applicant a contractor?

Does the applicant draw plans, designs or specifications for others?

Do any of the applicant's operations include blasting, utilizing or storing explosive material?

Do any of the applicant's operation's include excavation, tunneling, underground work or earth moving?

Does the applicant lease, rent or loan equipment to others with or without operators?

Does the applicant use subcontractors?

Do any of the applicant's subcontractors carry coverages or limits less than the applicant's?

Do contractors or subcontractors carry coverage with GL limits equal to or greater than the applicant?

Are the applicant's subcontractors allowed to work without providing the applicant with a certificate of insurance?

Please describe the type of work that the applicant subcontracts (if any)

List the applicant's annual subcontractor costs

What percentage of the applicant's work is subcontracted?

Does the applicant have heavy products or completed operations risk?

(If the applicant isn't a manufacturing or construction company, then the answer is probably no)

Please list the applicant's products and completed operations

Applicant's products and completed operations (Product description)

Applicant's products and completed operations (Annual gross sales)

Applicant's products and completed operations (number of units)

Is the applicant conducting research and development or planning new products?

Does the applicant provide guarantees, warranties or hold harmless agreements?

Does the applicant sell or re-package others' products under the applicant's label?

Are any of the applicant's products sold under other companies' labels?

Are any of the applicant's products sold under other companies' labels? (Yes)

Does the applicant require vendors coverage?

Do any of the named insured sell to to other named insureds?

Does the applicant have any exposure to radioactive or nuclear materials?

Does the applicant have past, present or discontinued operations involved in storing, treating, discharging, applying, disposing, or transporting of hazardous material (e.g. landfills, wastes, fuel tanks, etc.)?

Does the applicant have any operations sold, acquired or discontinued in the last five years?

Does the applicant rent, lease or loan equipment to others?

Does the applicant own, hire or lease any watercraft, docks or floats?

Does the applicant sponsor social events?

Does the applicant sponsor athletic teams?

Please describe the applicant's sponsorship of athletic teams

Please list each of the applicant's vehicles, if any

Applicant's vehicles VIN

Applicant's vehicles Make

Applicant's vehicles Model

Applicant's vehicles Body Type

Applicant's vehicles Garage Address

Applicant's vehicles Radius

Applicant's vehicles Use

Applicant's vehicles Coverages

Applicant's vehicles Deductibles

Applicant's vehicles Year

Does the applicant install, service or demonstrate products?

Does the applicant install, service or demonstrate products? (Yes)

Does the applicant sell, distribute or use foreign products as components?