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Alterations, Renovations or Repairs

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AC and refrigeration

AC and Refrigeration

Get a AC and refrigeration Contractor liability insurance quote

Acoustic Ceiling installation Contractors Insurance

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Blasting Contractors insurance

Complate online application

Restoration Contractor Insurance

Complate Application Online

PLEASE COMPLETE THE FORM FOR A QUICK QUOTE.

PLEASE MAKE SURE TO READ BELOW BEFORE COMPLETING THE FORM.

AFTER SUBMITTING YOUR FORM AND YOU RECEIVE THE MESSAGE One or more fields have an error. Please check THE FIELDS THAT ARE WRITTEN IN RED, COMPLETE THE MISSING INFORMATION ( IF NOTHING IS APPLICABLE ENTER NONE) and SUBMIT AGAIN. THE FORM WILL ONLY BE SUBMITTING ONCE ALL FIELDS ARE COMPLETED. ONCE THE FORM HAS BEEN SUCCESSFULLY SUBMITTED YOU WILL SEE Thank you for your message. It has been sent.

AC and refrigeration Contractors – Industrial and Commercial

Acoustic ceiling installation Contractors

Alarm system installationContractors  (not including sprinklers) 

BlastingContractors  – low hazard (If yes, please complete Blasting Liability Survey)

Bricklaying, masonry, stucco Contractors

Building cleaning Contractors – exterior (including sandblasting)

Building construction Contractors  – commercial – new & renovation

Building construction Contractors  – residential – new & renovation

Building raising or moving Contractors

Carpentry Contractors

Carpet and Upholstery cleaning Contractors

Chimney sweeping Contractors

Cleaning sewers and drains Contractors

Concrete – excluding sewers, tunnels, subway Contractors

Conveyor system installations

Crane and lift equipment operatorsDatatel Wiring

Demolition Contractors

Drywall & plastering Contractors

Duct cleaning Contractors

Electrician – Common Building Work Contractors

Electrician – Specialty (towers, main power lines, complex apparatus)

Elevators installation and service Contractors 

Excavation Contractors

Fence construction Contractors

Flooring Installation Contractors

Garden equipment repairs

Glazer Contractors

Heating Contractors (including oil and gas, but no gas hook up)

Heating Contractors (including gas hook up)

Home cleaners Contractors

Installation Contractors  – Windows, Awnings & Doors

Insulation installation Contractors

Interior decorating Contractors

Iron and steel construction Contractors

Water well drilling Contractors (no oil & gas or water testing)

Waterproofing Contractors

Window cleaning Contractors – 3 stories or less

Window cleaning Contractors– over 3 stories

Irrigation and Drainage Contractors – Commercial Applications

Irrigation and Drainage Contractors  – Residential

Janitorial contracting Contractors

Jetty, pier , dock construction Contractors

Landscape gardening – excluding tree removal

Locksmith Contractors (no alarm installation)

Machinery  Contractors– industrial installation

Painting (excluding exterior spray painting)

Painting Contractors  (including exterior spray painting)

Paving Contractor – Private Property

Paving Contractor – Public Roads / Government

Pest control Contractors

Pile driving Contractors

Plumbing Contractors

Remediation Contractor

Restoration Contractor

Roofing Contractors  – hot works (If yes, please complete Roofing Questionnaire)

Roofing Contractors – no hot works (If yes, please complete Roofing Questionnaire)

Sewer , water main, pipeline construction Contractors

Sheet metal installation Contractors – away from shop

Sheet metal installation Contractor – in shop operation

Sign installation Contractors (up to 3 stories)

Snow removal Contractors

Solar energy Contractors

Steam fitting Contractors

Tank installation Contractors – Other

Tank installationContractors  – Septic

Tent Set Up Contractors

Tiler Contractors

Underground cables Contractors

Underpinning of buildings Contractors

Video & Audio System – Installation Contractors

Video & Audio System – Repairs Contractors

Waste Collection Contractors

Water treatment equipment service and repair Contractors

WeldingContractors  – in shop (If yes, please complete Welding Questionnaire) 

Welding Contractors – off site (If yes, please complete Welding Questionnaire)

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    -------------------------Trade and Contractors Application ---------------- - - Applicant registered business name - Mailing Address Applicant’s Web Site Address Your Phone # (required) Applicant is: IndividualCorporationPartnershipJoint VentureLimited Liability Company 2. Year Company establishedYears of experience 3. Do any key personnel have over 15 years of experience? YesNo 4. Has applicant had any losses in last 5 years? YesNo If yes, please provide details 5. Is there a current insurance policy in force?YesNo If yes, Current Insurer: 6. Has any insurer ever cancelled, declined or refused to renew or issue insurance of the type applied for?YesNo If yes, please provide details 7. Has the applicant ever operated under a different name? If yes, please provide details 8. Have there been any claims against these prior entities? If yes, please provide details 9. Do all of your operations and sales take place strictly in Canada? Please provide details: LIABILITY COVERAGE INFORMATION 10. Do you assume liability under any hold harmless agreements or contracts? YesNo Please provide details 11. Please select the type(s) of operations performed and indicate the values requested below: AC and refrigeration – Industrial and CommercialAcoustic ceiling installationAlarm system installation (not including sprinklers)Blasting - low hazard (If yes, please complete Blasting Liability Survey)Bricklaying, masonry, stuccoBuilding cleaning – exterior (including sandblasting)Building construction – commercial – new & renovationBuilding construction - residential – new & renovationBuilding raising or movingCarpentryCarpet and Upholstery cleaningChimney sweepingCleaning sewers and drainsConcrete - excluding sewers, tunnels, subwayConveyor system installationsCrane and lift equipment operatorsDatatel WiringDemolitionDrywall & plasteringDuct cleaningElectrician – Common Building WorkElectrician – Specialty (towers, main power lines, complexapparatus)Elevators installation and serviceExcavationFence constructionFlooring InstallationGarden equipment repairsGlazerHeating (including oil and gas, but no gas hook up)Heating (including gas hook up)Home cleanersInstallation – Windows, Awnings & DoorsInsulation installationInterior decoratingIron and steel constructionWater well drilling (no oil & gas or water testing)WaterproofingWindow cleaning – 3 stories or lessWindow cleaning – over 3 storiesIrrigation and Drainage – Commercial ApplicationsIrrigation and Drainage – ResidentialJanitorial contractingJetty, pier , dock constructionLandscape gardening - excluding tree removalLocksmith (no alarm installation)Machinery – industrial installationPainting (excluding exterior spray painting)Painting (including exterior spray painting)Paving Contractor – Private PropertyPaving Contractor – Public Roads / GovernmentPest controlPile drivingPlumbingRemediation ContractorRestoration ContractorRoofing – hot works (If yes, please complete Roofing Questionnaire)Roofing – no hot works (If yes, please complete RoofingQuestionnaire)Sewer , water main, pipeline constructionSheet metal installation – away from shopSheet metal installation – in shop operationSign installation (up to 3 stories)Snow removalSolar energySteam fittingTank installation – OtherTank installation – SepticTent Set UpTilerUnderground cablesUnderpinning of buildingsVideo & Audio System - InstallationVideo & Audio System - RepairsWaste CollectionWater treatment equipment service and repairWelding – in shop (If yes, please complete Welding Questionnaire)Welding – off site (If yes, please complete Welding Questionnaire) Description of Operations - to be selected from Operations Actual Gross Revenue in the past 12 months $ Projected % to be subcontracted What percentage of the operations are: Commercial:Residential: 12. Please describe “scope of services”: 13. Provide details of most recent/largest project: 14. Do you subcontract any work to others? YesNo If yes, what percentage of your work is subcontracted? % If yes, do you always confirm (by way of collecting Certificates/Proofs of Insurance) that subcontractors have CGL coverage with a min. limit of $2M in place?YesNo 15. Do retail sales of products make up more than 30% of total annual receipts? YesNo Please describe details: 16. Do revenues from renting or leasing equipment make up more than 30% of total annual receipts? YesNo Please describe details 17. Do you or any of your staff perform original design, inspection for fee, or consulting services?YesNo Please describe details 18. Please check the box for any work carried out for/involving any of the following: Airport WorkBlasting / Use of Explosives (If yes, pleasecomplete Blasting Liability Survey)Building Envelope Repair/RestorationCaissonsContaminated SitesDamsExcavatingFire Extinguishing ServicesGas Main WorkLogging / MiningOil & Gas Field ProductionOpen Fire WorkPool & Hot Tub InstallationRadioactive MaterialsRailway WorkRaising or Moving BuildingsReservoir ConstructionScaffolding / Temporary StandsShoring/UnderpinningSnow RemovalTunneling / Bridging 19. Deductible:$1,000$2,500$5,000 20. NOA SPF No. 6:$1 Million$2 Million$5 Million 21. Tenants Legal Liability: $500,000$1 Million$2 Million 22. Do you require any coverage for equipment and/or tools? YesNo 23. Tools (ACV): $ 24. Equipment (ACV) - over 3 years old: $ 25. Equipment (RC) - less than 3 years old: $ 26. If applicable, description of equipment to be included (attach separate schedule if needed): 27. Installation floater limit required : $ Limit of Liability:$1 Million$2 Million$5 Million Optional E&O Coverage Limit:None – n/a$100,000$250,000$500,000 Where (a) an Applicant for this contract gives false particulars to the prejudice of the insurer or knowingly misrepresents or fails to disclose any fact in any part of this application required to be stated therein; or (b) the insured contravenes a term of the contract or commits a fraud; or (c) the Insured willfully makes a false statement in respect of a claim, a claim will become invalid and the Insured’s right of recovery is forfeited. The Applicants have reviewed all parts and attachments of this application and acknowledge that all information is true and correct and understand that this application for insurance is based on the truth and completeness of this information. I have provided personal information in this document and otherwise and I may in the future provide further personal information. Some of this personal information may include, but is not limited to, my credit information and claims history. I authorize my broker or insurance company to collect, use and disclose any of this personal information, subject to the law and my broker’s or insurance company’s policy regarding personal information, for the purpose of communicating with me, assessing my application for insurance and underwriting my policies, evaluating claims, detecting and preventing fraud, and analyzing business results. I confirm that all individuals whose personal information is contained in this document have authorized that I agree to the above on their behalf Printed Name:Position Held: Date:
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