General Liability Insurance Quotes

Form data will be submitted via a secure connection.Please take a moment to fill out the General Liability Questionnaire which will be assigned to a team member. Your information will be kept confidential and will only be used for quoting purposes.
  • Fill out the questionnaire and return it via email.

  • All policies are subject to audits. Underestimating Payroll, Gross Receipts or Sub Costs can result in additional premium at time of an Audit..
  • ESTIMATED EXPOSURE

  • For purposes of this application, Employee is defined as an individual working for you (the applicant), which receives a w-2 tax form or you withhold & pay employment related taxes for that individual.

  • “New residential” work is defined as work being performed on newly constructed properties that are not yet certified for occupancy.
  • Out of 100%, New Construction vs. Remodels

  • Out of 100%, Residential vs. Commercial

  • Out of 100%, Interior vs. Exterior

  • If YOU USE SUBCONTRACTORS

  • COMPANY OPERATIONS

  • Provide a Brief description of your business operations:
  • Will your upcoming work involve any “NEW” Construction in:

  • Do you do work on “New” Condominiums, townhouses, apartments or tract homes over 25 units at any one time, except for repair or remodeling within a development at any given time?

  • ENDORSEMENTS

  • ROOFING

  • Warranty: The purpose of this Questionnaire is to assist in the underwriting process. Information contained herein is speci cally relied upon in determination of insurability. The undersigned, there- fore warrants that the information contained herein is true and accurate to the best of his knowledge, information and belief. This Questionnaire and the application to which it is appended, shall be the basis of any insurance policy that may be issued and will be part of such policy.
  • Are you interested in having us quote any of the following coverages?

  • This field is for validation purposes and should be left unchanged.
July 18th, 2016 by Clear Choice Insurance