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Contractor Insurance
Cheap Small Business Insurance, Contractors save $800 n more a year in California, Save BIG!, Call our agent Melissa on 800-200-0774 for more discounts.
SSIS Contractors Insurance, California
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» Required Fields
» Owner-President Name:
» Address:
» City:
» State:
» Zip Code:
» Day Phone:
» Email :
Cell Phone:
Currently Insured:
» Proposed effective date: month:  date:   year:     
» Number of total years continuously insured:
Name of most current insurance company:
» Business Name:
» Doing Business As (DBA Name):
» Total Years of Experience:
» Years in Business:
Incorporation Type:
» Contractor License No:
Business / Contractor Type:
» Describe business operation:
                 
Structural work?
Remodeling Repair Work?
New Construction ?
Residential Work ?
Commercial Work ?
Work for, Maximum Number of Stories
Work for, Maximum Depth Below Grade
No of Employees:
Total Payroll:
Total Gross Receipts:
Has any licensing authority taken any action against?
Have you allowed or will you allow your license to be used by any other contractor?
Do you use subcontractors?
Do you have a standard formal written contract with subcontractors?
Do you require sub-contractors to carry Worker’s Compensation?
Total Subcontractor Costs:
Has a third party ever made a claim against your business or do you know of any reason why someone may make a future claim:

If there has been any cliams against your business please give the details (Please explain the nature of the claim(s) or reason why you expect a claim to be made, when it occurred, the parties involved, the amount of loss and whether it is still pending or has been resolved):
                 
Is this HOME BASED BUSINESS:
(You may get additional discount)


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