1594 N. Batavia Street
Orange, CA 92867
(714) 524-4949 Office
(714) 524-4940 Fax

Builders Risk and Installation Coverage

Posted on | May 30, 2011 | No Comments

 

Specific Project Questionnaire


Date (required)

Named insured (required)

Email Address (required)

Specific Location of project (required)

Description of project and specific work to be performed including materials used:

 

What portion of work is below ground and maximum depth:

What portion of work will be subbed out to others:

 

Please describe work subbed to others:

Length of project / time to complete:

 

What security will be provided at a job site:

Cost of Contract:
$

How much of this is attributable to actual property value at risk:
$



Does the job require and/or do you want this quote to include:

Earthquake Insurance:

Flood Insurance:





* Perils of Earthquake and Flood requires additional information.

** Location information to include complete address and/or cross streets where available or sufficient information for the location to be mapped for Earthquake and/or Flood Zone determination.

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