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Contractors Insurance
Contractors Insurance Quote
This application shall not be binding on the Underwriters unless and until a contract of insurance is issued and delivered in accordance herewith and then only as the commencement date of said insurance and in accordance with all terms thereof. The Applicant hereby covenants and agrees to and with the Underwriters that the foregoing statements and answers fully and truly represent, to the best of the Applicant's knowledge, all the facts and circumstances with regard to the risk to be insured. The Applicant also agrees that the answers and statements contained herein form the basis and conditions of the insurance.

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Company Information (*indicates required field)
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About Your Business
Number of owner/officers:
Number of Locations:
Business Classification:*
Own or Lease Office:
Number of Employees: *
Year Established:
Description of Business Operations:*
Insurance Details
Are you a subsidary of another entity or do you have any subsidaries?  
Is a formal safety program in operation?  
Any exposure to flammables,explosives or chemicals?  
Any other insurance with Skyline Services Insurance?  
Any catastrophe exposure?  
Do you draw plans, designs, or specifications?  
Do any operations include excavation, tunneling, underground work, or earth moving?  
Do you lease or loan machinery/equipment to others?  
Any exposure to radioactive/nuclear materials?  
Are there any past, present or discontinued operations that involve storing, treating, discharging, applying, disposing, or transporting of hazardous materials?  
Any operations sold/acquired or discountinued in the last 5 years?
Do any operations include blasting or utilize or store explosive material?  
If you answered yes to any of the above, please explain:
Are subcontractors certificates of insurance kept current and on file?  
Are subcontractors required to carry limits equal to yours?  
Percentage of work subcontracted.
Describe type of work subcontracted:
Prior Carrier Details
List Prior Carriers (Last 3 years) W/Expiring Premiums:
Did They:
If you answered the above question, please explain:
Claim Records (Last 3 Years)
Date of Loss Description of Loss Amount Paid