General Contractor's Questionnaire

If you will provide us with the information listed below, we will have a quote within 2 business days. We can respond via email, telephone, fax or regular mail. Let us know what is most convenient.

General Information Company name:    Contact name:    Address:    City:      State:   Zip: Phone Number:      Fax #:  Email Address:     Preferred Contact Method:   Phone  Fax  Mail  Email  Description of Operations   As a General Contractor, what do you do? Total number of employees including the owner:   Total estimated annual gross sales for the next 12 months: $  Total estimated employee payroll for the next 12 months: $  Total estimated payments to subs for the next 12 months: $  Are you including materials in this number? Yes   No   Out of those subs, how many are insured and how many are not insured?: # Insured:   # Not Insured:   Do you get certificates from them? Yes   No     Of the uninsured subs, please list below, broken down by type of work.   For instance, if you have $500,000 in uninsured sub work, you might have $100,000   in electrical, $150,000 in roofing, $75,000 in plumbing, $75,000 in drywall, $50,000   in masonry and $50,000 in clean up. Do you currently carry general liability? Yes   No   If so, with what carrier?   Out of total gross receipts, how much is residential, how much is commercial?: Residential: $  Commercial: $  Have you had any insurance claims in the last 3 years? Yes   No   If "Yes", give as much detail as you can below:   Additional Comments Please list any additional information, comments, or questions below:  Submit Your Application Please click on the "Submit Request" button to send your quote request. One of our representatives will respond to your submission as soon as possible.