• Name * Required
  • Address * Required
  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • Any General Liability Losses Paid/Reserved?
  • Any Workers Comp Losses Paid/Reserved?
  • Any Property or Equipment Losses Paid/Reserved?
  • Any Bid or Performance Bonds Issued?

In order to provide you with competitive quotes for contractors who use subcontractors, we will need the following items available when we meet:

  • A copy of the written agreement that you ask your subcontractors to sign when hiring them to perform subcontracted work
  • A copy of your Workers Comp “Mod Sheet” – (the NCCI document which shows your firm’s Experience Modification Factor and WC claims history)
  • 5 year, printed Company Loss Runs, currently valued for all lines submitted (available from your agent)
  • A listing of all currently active jobsites

We will contact you to obtain further information that may be needed to respond to your request.