Contractors General Liability Application Name*Phone*Email* LocationLocation Address* Street Address City State / Province / Region ZIP / Postal Code Is your mailing address the same as your location address?YesNoMailing Address Street Address City State / Province / Region ZIP / Postal Code OperationsWhat kind of work do you perform?*Select your primary operation.Appliance Installation or Repair - HouseholdApplicance Installation or Repair - CommercialCarpentry ServicesCeling or Wall InstallationConcreteDebris Removal - Construction SiteDrywallElectrical WorkExcavationGeneral ContractorGlass/ GlazierGrading of LandHandymanHVAC and RefrigerationInterior constructionLogging and LumberingMasonryPaintingPainting ExteriorPainting InteriorPaperhangingPaving or RepavingPermanent Yards ContractorsPlastering or Stucco workPlumbing CommercialPlumbing ResidentialPrefabricated Building ErectionProperty PreservationRoofing CommercialRoofing ResidentialSheet Metal WorkSign Painting InsideSign painting OutsideSnow Plowing/ Ice RemovalTile/Stone/marble/Mosaic/Terrazzo InstallationTree TrimmingOther / Not ListedEstimates1. Annual Gross Sales (Estimated)*Gross sales are the total amounts (before expenses) that a company earns and records from the sales of its products or services. 2. Number of Owners, Officers, Partners or LLC Members01234+3. Number of Employees012 - 56 - 1011+3a. Annual Employee Payroll (Estimated)*Please do not include payroll for any owners, officers, partners or members.4. Do you ever hire subcontractors?YesNo4a. What percentage of your gross sales do you pay to subcontractors?%5% or less10%15%20%25%30%35%40%45%50%55%60%65%70%75%80%85%90%95% Additional Questions About Your Work5. Describe your largest job in the past 3 years.*City and StateType of WorkContract Value6. Describe your largest planned job.City and StateType of WorkContract Value7. Type of JobsitesResidential*Please enter a number from 0 to 100.Commercial*Please enter a number from 0 to 100.Other*Please enter a number from 0 to 100.8. Type of ProjectsNew Construction*Please enter a number from 0 to 100.Roofing on a new building.Remodeling / Renovation*Please enter a number from 0 to 100.Replacing an existing roof.Service and Repair*Please enter a number from 0 to 100.Small jobs. Patch work. Questions? Call 800-858-1315
