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What type of insurance quote do you need?General Contractor InsuranceTowing Operations InsuranceBusiness InsuranceWorkers Compensation InsuranceCommercial Auto InsuranceLegal Business Name *Business Address *City *State/ProvinceZIP / Postal CodeContact Name *Phone Number *Email Address *Years in Business *012345+Estimated Annual Revenue *Previous Insurance Coverage *Please select an optionYesNoClaims in the Past Six Years *Please select an optionYesNoDBA / Doing Business AsMailing Address (if different)Business Contents ValueLiability Coverage Limit DesiredAdditional Comments or Special NeedsFirst Name *Last NameDate of Birth *Phone Number *Email *Street Address *CityState/ProvinceZIP / Postal CodeVIN Number(s) for At Least One Vehicle *Type of Coverage *Please select an optionLiabilityFull CoverageAdditional Driver(s) InformationNameDates of BirthDriver’s License NumbersCurrently Insured or Uninsured? *Please select an optionInsuredUninsuredClaims in the Past Six Years *Please select an optionYesNoTotal Square Footage of Location *Owner or Tenant *Please select an optionOwnerTenantCurrently Insured? *Please select an optionYesNoFederal Employer Identification Number (FEIN) *Total Annual Payroll *Number of Employees *Type of ContractingClaims in the Past 3 Years? *Please select an optionYesNoDesired Liability Coverage LimitTools/Equipment Coverage Needed?Additional Comments or Coverage NeedsEstimated Annual Liquor Sales *Hours of Operation *Type of Establishment *EntertainmentType of Establishment (e.g., bar, liquor store, gas station, nightclub, etc) *We specialize in insurance for General Contractors. This form is required to provide an accurate, bindable quote and issue your policy and certificates quickly. If you’re unable to complete the form or need help, feel free to call or text us at 773-990-9889 for assistance.Business Name (as it should appear on the policy) *Mailing Address *Business Address (if different) *Website AddressProposed Effective Date (MM/DD/YYYY) *Applicant Type (e.g., Individual, Corporation, Partnership, Other): *Has the insured had 3 years of prior coverage? *Please select an optionSelectYesNoAny prior claims or losses in last 3 years? *Please select an optionSelectYesNoExplainDescribe exact operations *Years in business under business name *Approximate % of work by property type (e.g., Residential, Commercial, Industrial) – Total = 100% *Approximate % of work by project type (e.g., New Construction, Structural Remodeling, Non-Structural Remodeling) – Total = 100% *Approximate % of your work as: General Contractor, Subcontractor, Construction Manager (Total = 100%) *License type (e.g., General Contractor, Other): *Do you use subcontractors? *Please select an optionSelectYesNoInclude % subcontracted, total value, and trades with %Approximate Annual Revenue for the Last 5 Years (List Year + Amount, e.g., 2024: $X, 2023: $Y, etc.) *Projected annual revenue for this year: *Number of active owners/officers: *Number of non-owner employees: *Approx Annual Payroll for Last 5 Years (List by year – most recent first, e.g., 2024: $X, 2023: $Y…) *Estimated Annual Payroll for Upcoming Year (Approx total for 2025) *Approximate Payroll by Job Type (e.g., Carpenter: $X, Laborer: $Y…) *List Your 4 Largest Completed Projects + Their Values (e.g., Project Name – $X) *List Your 4 Largest Upcoming Projects + Estimated Values (e.g., Project Name – $X) *Do you construct new buildings? *Please select an optionSelectYesNoIndicate Residential and/or Commercial:Do you work on condos, apartments, or tract homes? *Please select an optionSelectYesNoInclude type, location, year, valueWill you do similar work in future? *Please select an optionSelectYesNowhen and what kind?:Do you perform seismic or earth movement work? *Please select an optionSelectYesNoDescribe:List all types of work you perform (e.g., demolition, blasting, roofing, mold remediation) *Any work below grade? *Please select an optionSelectYesNoApproximate average and maximum depth below ground (in feet):Exterior painting? *Please select an optionSelectYesNoDescribe overspray precautions:Concrete work for additions or foundations? *Please select an optionSelectYesNoDescribeEquipment leased from others? *Please select an optionSelectYesNoDescribeHazardous material removal? *Please select an optionSelectYesNoDescribe:Do you draw your own plans or blueprints? *Please select an optionSelectYesNoDescribe:Work on hillsides/slopes/landfills/subsidence areas? *Please select an optionSelectYesNoDescribe and provide slope:Work above 4 stories? *Please select an optionSelectYesNoApproximate % of total work done above 4 stories and max working height (in feet)Use scaffolding? *Please select an optionSelectYesNoList all U.S. states you currently operate in: *Additional comments or notes:Business Name: *Mailing Address (City, State, Zip): *Business Location (if different from mailing address): *Primary Contact Name & Phone: *Briefly describe your towing business: (What types of towing do you do? Light duty? Heavy duty? Roadside? Impound? Etc.) *What year did your business start? *Total years of towing industry experience: *Revenue & Operation Area:Annual Revenue: Last Year + This Year (e.g., 2023: $X, 2024: $Y): *Do you operate in multiple states? *Please select an optionSelectYesNoList statesLargest city you operate in: *Driver Info:Driver Info: Name, DOB, License #, State, License Class, Years Experience: *Driver Pay Basis (Hourly, Per Trip, Mileage, Other): *Are drivers covered by Workers Comp? *Please select an optionSelectYesNoMinimum required driving experience (years): *Do drivers take vehicles home at night? *Please select an optionSelectYesNoVehicles & Equipment:Number + Types of Vehicles Owned (list type & quantity): *Any Vehicles Leased to You? *Please select an optionSelectYesNoList type and quantityAny insurance declined, cancelled, or non-renewed? *Please select an optionSelectYesNoExplainHow many Tow Trucks in operation? *Do you operate Tow Tractor/Trailer Combos? *Please select an optionSelectYesNoMax Number of Units Towed by One Truck: *Storage & Security (Optional – Skip if Not Applicable):If you do not store customer vehicles, you can skip these questions.Number of Vehicle Storage Locations:Maximum Number of Customer Vehicles Stored (at one time):Are Customer Vehicles Stored Overnight?SelectYesNoIs Your Storage Yard Fenced and Lighted?SelectYesNoWhere Do You Store Customer Vehicle Keys?Do You Perform Repo Work?SelectYesNo% of Total Tows That Are ReposRepo Section (Only Answer If You Perform Repossessions):If your business does not perform repossessions, you can skip this section.Briefly Describe Your Repo Procedure:Do You Drive Any Vehicles Away After Repossession?SelectYesNoNumber of Repo Plates + Plate NumbersDo You Use Independent Contractors for Repos?SelectYesNoNumber of Vehicles Repossessed Last Year (By Tow Truck / Drive-Away / Subcontractor – list qty for each):Repo Types by % (Private Auto, Light Truck, Heavy Truck, Trailer, Other – Total = 100%):Approx % of Repos That Were Voluntary vs Involuntary:Do Repo Employees Carry Firearms?SelectYesNoDo You Notify Police for Repos?SelectYesNoWho Are Your Primary Repo Clients (Lenders, Finance Companies, etc.):Get My Free Quote