General Liability and Builder's Risk Insurance Application Instructions
This form contains 167 fields organized into 55 sections. Below is a complete list of every field, its type, and what information is expected.
| Field Name | Type | Description |
|---|---|---|
| Agency Mailing Address | ||
| Agency Mailing Address | Text |
Enter the complete mailing address of the agency. Fill only if 'State' requires agent/broker information to be provided.
Depends on:
State
|
| City | Text |
Enter the city part of the agency's mailing address. Fill only if 'State' requires agent/broker information to be provided.
Depends on:
State
|
| State | Text |
Enter the state part of the agency's mailing address.
|
| Zip Code | Text |
Enter the five or nine-digit zip code for the agency's mailing address. Fill only if 'State' requires agent/broker information to be provided.
Depends on:
State
|
| Applicant as GC by Trade Question | ||
| Yes | Radiobutton |
Check this box if the applicant is a general contractor by trade. Fill only if 'No' is 'Yes'.
Depends on:
No
|
| No | Radiobutton |
Check this box if the applicant is not a general contractor by trade. Fill only if 'No' is 'Yes'.
Depends on:
No
|
| Applicant as GC Question | ||
| Yes | Radiobutton |
Check this box if the applicant is acting as the general contractor for this project. Fill only if 'No' is 'Yes'.
Depends on:
No
|
| No | Radiobutton |
Check this box if the applicant is NOT acting as the general contractor for this project. Fill only if 'No' is 'Yes'.
Depends on:
No
|
| Applicant Contact Information | ||
| Web Address | Text |
Provide the official website address for the applicant.
|
| Email Address | Text |
Enter the primary email address for the applicant.
|
| Phone Number | Text |
Provide the primary phone number for the applicant.
|
| Applicant Name | ||
| Applicant's Name | Text |
Please provide the applicant's name, which can include the legal entity and/or DBA name.
|
| Blasting Operations Status | ||
| Yes | Radiobutton |
Check this box if there are blasting operations. Fill only if 'General liability' is 'Yes'.
Depends on:
General liability
|
| No | Radiobutton |
Check this box if there are no blasting operations. Fill only if 'General liability' is 'Yes'.
Depends on:
General liability
|
| Building Construction Type | ||
| Frame | Radiobutton |
Check this box if the building construction type is Frame. Fill only if 'Builder's risk/Property' is 'Yes'.
Depends on:
Builder's risk/Property
|
| Joisted masonry | Radiobutton |
Check this box if the building construction type is Joisted masonry. Fill only if 'Builder's risk/Property' is 'Yes'.
Depends on:
Builder's risk/Property
|
| Noncombustible | Radiobutton |
Check this box if the building construction type is Noncombustible. Fill only if 'Builder's risk/Property' is 'Yes'.
Depends on:
Builder's risk/Property
|
| Masonry non-combustible | Radiobutton |
Check this box if the building construction type is Masonry non-combustible. Fill only if 'Builder's risk/Property' is 'Yes'.
Depends on:
Builder's risk/Property
|
| Modified fire resistive | Radiobutton |
Check this box if the building construction type is Modified fire resistive. Fill only if 'Builder's risk/Property' is 'Yes'.
Depends on:
Builder's risk/Property
|
| Fire resistive | Radiobutton |
Check this box if the building construction type is Fire resistive. Fill only if 'Builder's risk/Property' is 'Yes'.
Depends on:
Builder's risk/Property
|
| Building Demolition Schedule | ||
| Yes | Radiobutton |
Check this box if there is an existing building scheduled for demolition during the policy term.
|
| No | Radiobutton |
Check this box if there is no existing building scheduled for demolition during the policy term.
|
| Building Details | ||
| Text | ||
| Total Square Feet | Number |
Enter the total square footage of the building. Fill only if 'Builder's risk/Property' is 'Yes'.
Depends on:
Builder's risk/Property
|
| Number of Stories | Text |
Enter the total number of stories in the building. Fill only if 'Builder's risk/Property' is 'Yes'.
Depends on:
Builder's risk/Property
|
| Business Operations Prior to Completion | ||
| Yes | Radiobutton |
Check this box if the applicant will be conducting business operations prior to the completion of the project. Fill only if 'General liability' is 'Yes'.
Depends on:
General liability
|
| No | Radiobutton |
Check this box if the applicant will NOT be conducting business operations prior to the completion of the project. Fill only if 'General liability' is 'Yes'.
Depends on:
General liability
|
| Construction Work Status | ||
| Yes | Radiobutton |
Check this box if construction work has already started, excluding site preparation.
|
| No | Radiobutton |
Check this box if construction work has not yet started, excluding site preparation.
|
| Deductible | ||
| $1,000 | Radiobutton |
Select this option if the desired deductible amount is $1,000. Fill only if 'Builder's risk/Property' is 'Yes'.
Depends on:
Builder's risk/Property
|
| $2,500 | Radiobutton |
Select this option if the desired deductible amount is $2,500. Fill only if 'Builder's risk/Property' is 'Yes'.
Depends on:
Builder's risk/Property
|
| $5,000 | Radiobutton |
Select this option if the desired deductible amount is $5,000. Fill only if 'Builder's risk/Property' is 'Yes'.
Depends on:
Builder's risk/Property
|
| Description of Operations | ||
| Description of Operations | Text |
Please provide a detailed description of the operations for the business.
|
| Estimated Project Dates | ||
| Estimated Start Date | Date |
Provide the estimated start date for the project.
|
| Estimated Completion Date | Date |
Provide the estimated completion date for the project.
|
| Exterior Operations Height | ||
| Yes | Radiobutton |
Check this box if there are any exterior operations over four stories or more than 50 feet from ground level. Fill only if 'General liability' is 'Yes'.
Depends on:
General liability
|
| No | Radiobutton |
Check this box if there are no exterior operations over four stories or more than 50 feet from ground level. Fill only if 'General liability' is 'Yes'.
Depends on:
General liability
|
| First Additional Interest | ||
| First Additional Interest Name | Text |
Enter the full name of the first additional interest. Fill only if 'General liability' is 'Yes'.
Depends on:
General liability
|
| First Additional Interest Relationship | Text |
Enter the relationship or interest type for the first additional interest (e.g., Additional Insured, Loss Payee, Mortgagee). Fill only if 'General liability' is 'Yes'.
Depends on:
General liability
|
| First Additional Interest Address | Text |
Enter the street address for the first additional interest. Fill only if 'General liability' is 'Yes'.
Depends on:
General liability
|
| First Additional Interest City, State, Zip Code | Text |
Enter the city, state, and zip code for the first additional interest's address. Fill only if 'General liability' is 'Yes'.
Depends on:
General liability
|
| Additional Insured | Radiobutton |
Check this box if the first additional interest should be designated as an Additional Insured. Fill only if 'General liability' is 'Yes'.
Depends on:
General liability
|
| Loss Payee | Radiobutton |
Check this box if the first additional interest should be designated as a Loss Payee. Fill only if 'General liability' is 'Yes'.
Depends on:
General liability
|
| Mortgagee | Radiobutton |
Check this box if the first additional interest should be designated as a Mortgagee. Fill only if 'General liability' is 'Yes'.
Depends on:
General liability
|
| Waiver of Transfer of Rights of Recovery Against Others to Us | Radiobutton |
Check this box if a Waiver of Transfer of Rights of Recovery Against Others to Us applies to the first additional interest. Fill only if 'General liability' is 'Yes'.
Depends on:
General liability
|
| First Loss Record | ||
| Property | Radiobutton |
Check this box if the first recorded loss was a property loss. Fill only if 'Yes' is 'Yes'.
Depends on:
Yes
|
| Liability | Radiobutton |
Check this box if the first recorded loss was a liability loss. Fill only if 'Yes' is 'Yes'.
Depends on:
Yes
|
| First Loss Date | Date |
Please enter the date when the first loss occurred. Fill only if 'Yes' is 'Yes'.
Depends on:
Yes
|
| First Loss Description | Text |
Please provide a detailed description of the first loss. Fill only if 'Yes' is 'Yes'.
Depends on:
Yes
|
| First Loss Paid Amount | Number |
Please enter the amount paid for the first loss. Fill only if 'Yes' is 'Yes'.
Depends on:
Yes
|
| First Loss Reserved Amount | Number |
Please enter the amount reserved for the first loss. Fill only if 'Yes' is 'Yes'.
Depends on:
Yes
|
| Open | Radiobutton |
Check this box if the status of the first recorded loss is currently open. Fill only if 'Yes' is 'Yes'.
Depends on:
Yes
|
| Closed | Radiobutton |
Check this box if the status of the first recorded loss is closed. Fill only if 'Yes' is 'Yes'.
Depends on:
Yes
|
| Foreclosures/Bankruptcies Status | ||
| Yes | Radiobutton |
Check this box if there are any past, pending, or planned foreclosures, bankruptcies, or judgments for unpaid taxes against the named insured or any officer, partner, member, or owner within the past five years.
|
| No | Radiobutton |
Check this box if there are no past, pending, or planned foreclosures, bankruptcies, or judgments for unpaid taxes against the named insured or any officer, partner, member, or owner within the past five years.
|
| Form of Business | ||
| Individual | Radiobutton |
Check this box if the form of business is an individual.
|
| Corporation | Radiobutton |
Check this box if the form of business is a corporation.
|
| Partnership | Radiobutton |
Check this box if the form of business is a partnership.
|
| Nonprofit Corporation | Radiobutton |
Check this box if the form of business is a nonprofit corporation.
|
| Trust | Radiobutton |
Check this box if the form of business is a trust.
|
| Other | Radiobutton |
Check this box if the form of business is not one of the other listed options.
|
| Other Form of Business | Text |
Specify the form of business if it is not one of the listed options. Fill only if 'Other' is 'Yes'.
Depends on:
Other
|
| GC Insurance Certificate Question 1 | ||
| Yes | Radiobutton |
Check this box if the general contractor provides a certificate of insurance showing general liability limits of at least $1million/$2million with the applicant listed as an additional insured. Fill only if 'Yes' is 'Yes'.
Depends on:
Yes
|
| No | Radiobutton |
Check this box if the general contractor does not provide a certificate of insurance showing general liability limits of at least $1million/$2million with the applicant listed as an additional insured. Fill only if 'Yes' is 'Yes'.
Depends on:
Yes
|
| GC Insurance Certificate Question 2 | ||
| Yes | Radiobutton |
Check this box if the general contractor provides a certificate of insurance showing general liability limits greater than $1million/$2million with the applicant listed as an additional insured. Fill only if 'Yes' is 'Yes'.
Depends on:
Yes
|
| No | Radiobutton |
Check this box if the general contractor does not provide a certificate of insurance showing general liability limits greater than $1million/$2million with the applicant listed as an additional insured. Fill only if 'Yes' is 'Yes'.
Depends on:
Yes
|
| General | ||
| Signature | ||
| Signature | ||
| General Contractor Contract Question | ||
| Yes | Radiobutton |
Check this box if the applicant is entering into a written contract with one general contractor.
|
| No | Radiobutton |
Check this box if the applicant is not entering into a written contract with one general contractor.
|
| General Contractor Name | ||
| General Contractor Name | Text |
Please provide the full name of the general contractor. Fill only if 'Yes' is 'Yes'.
Depends on:
Yes
|
| Inspection Contact Information | ||
| Inspection Contact Name | Text |
Please provide the full name of the primary contact person for inspection-related matters.
|
| Inspection Contact Email Address | Text |
Please provide the email address for the inspection contact.
|
| Inspection Contact Phone Number | Text |
Please provide the phone number for the inspection contact.
|
| Insurance Coverage Status | ||
| Yes | Radiobutton |
Check this box if insurance coverage has been cancelled or non-renewed in the past three years.
|
| No | Radiobutton |
Check this box if insurance coverage has NOT been cancelled or non-renewed in the past three years.
|
| Intended Future Occupancy | ||
| Residential | Radiobutton |
Check this box if the intended future occupancy of the building is residential.
|
| Commercial | Radiobutton |
Check this box if the intended future occupancy of the building is commercial.
|
| Large Open Atriums Inclusion | ||
| Yes | Radiobutton |
Check this box if the project includes any large open atriums equaling three stories or more. Fill only if 'Builder's risk/Property' is 'Yes'.
Depends on:
Builder's risk/Property
|
| No | Radiobutton |
Check this box if the project does not include any large open atriums equaling three stories or more. Fill only if 'Builder's risk/Property' is 'Yes'.
Depends on:
Builder's risk/Property
|
| Liability Occurrence Limit | ||
| $100,000/$200,000 | Checkbox |
Check this box if the desired liability occurrence limit is $100,000/$200,000. Fill only if 'General liability' is 'Yes'.
Depends on:
General liability
|
| $300,000/$600,000 | Checkbox |
Check this box if the desired liability occurrence limit is $300,000/$600,000. Fill only if 'General liability' is 'Yes'.
Depends on:
General liability
|
| $500,000/$1,000,000 | Checkbox |
Check this box if the desired liability occurrence limit is $500,000/$1,000,000. Fill only if 'General liability' is 'Yes'.
Depends on:
General liability
|
| $1,000,000/$2,000,000 | Checkbox |
Check this box if the desired liability occurrence limit is $1,000,000/$2,000,000. Fill only if 'General liability' is 'Yes'.
Depends on:
General liability
|
| $1,000,000/$3,000,000 | Checkbox |
Check this box if the desired liability occurrence limit is $1,000,000/$3,000,000. Fill only if 'General liability' is 'Yes'.
Depends on:
General liability
|
| Lift-Slab/Tilt-Up Construction Methods | ||
| Yes | Radiobutton |
Check this box if the project includes any lift-slab or tilt-up construction methods. Fill only if 'Builder's risk/Property' is 'Yes'.
Depends on:
Builder's risk/Property
|
| No | Radiobutton |
Check this box if the project does not include any lift-slab or tilt-up construction methods. Fill only if 'Builder's risk/Property' is 'Yes'.
Depends on:
Builder's risk/Property
|
| Location Address | ||
| Location Street Address | Text |
Please provide the street address for the location.
|
| Location City | Text |
Please provide the city for the location.
|
| Location State | Text |
Please provide the state for the location.
|
| Location Zip Code | Text |
Please provide the zip code for the location.
|
| Loss History Question | ||
| Yes | Radiobutton |
Check this box if there have been any property or liability losses in the last three years.
|
| No | Radiobutton |
Check this box if there have been no property or liability losses in the last three years.
|
| Mailing Address | ||
| Mailing Address Line 1 | Text |
Please provide the first line of the mailing address.
|
| Mailing Address City | Text |
Please provide the city for the mailing address.
|
| Mailing Address State | Text |
Please provide the state for the mailing address.
|
| Mailing Address Zip Code | Text |
Please provide the zip code for the mailing address.
|
| Modular Home Question | ||
| Yes | Radiobutton |
Check this box if the project is a modular home project. Fill only if 'Builder's risk/Property' is 'Yes'.
Depends on:
Builder's risk/Property
|
| No | Radiobutton |
Check this box if the project is not a modular home project. Fill only if 'Builder's risk/Property' is 'Yes'.
Depends on:
Builder's risk/Property
|
| page 1 of 4 | ||
| Carrier | Text |
Please provide the name of the insurance carrier.
|
| General liability | Checkbox |
Check this box if you desire General Liability coverage.
|
| Builder's risk/Property | Checkbox |
Check this box if you desire Builder's Risk or Property coverage.
|
| Page 4 | ||
| Applicant's Title | Text |
Enter the applicant's official job title or position. Fill only if 'Have there been any property or liability losses in the last three years?' is 'Yes'.
Depends on:
Yes
|
| Date Signed | Date |
Provide the date when the application was signed. Fill only if 'Have there been any property or liability losses in the last three years?' is 'Yes'.
Depends on:
Yes
|
| Policy Term | ||
| 3 months | Checkbox |
Check this box if the desired policy term is 3 months.
|
| 6 months | Checkbox |
Check this box if the desired policy term is 6 months.
|
| 9 months | Checkbox |
Check this box if the desired policy term is 9 months.
|
| 12 months | Checkbox |
Check this box if the desired policy term is 12 months.
|
| Project on Filled Ground Status | ||
| Yes | Radiobutton |
Check this box if the project is built on filled ground. Fill only if 'Builder's risk/Property' is 'Yes'.
Depends on:
Builder's risk/Property
|
| No | Radiobutton |
Check this box if the project is not built on filled ground. Fill only if 'Builder's risk/Property' is 'Yes'.
Depends on:
Builder's risk/Property
|
| Project Site Fence Question | ||
| Yes | Radiobutton |
Check this box if the project site will be protected by a fence when workers are not present.
|
| No | Radiobutton |
Check this box if the project site will not be protected by a fence when workers are not present.
|
| Property Ownership Question | ||
| Yes | Radiobutton |
Check this box if the applicant is the property owner.
|
| No | Radiobutton |
Check this box if the applicant is not the property owner.
|
| Retail Agency Information | ||
| Retail Agency Name | Text |
Provide the full legal name of the retail agency. Fill only if 'State' requires agent/broker information to be provided.
Depends on:
State
|
| License Number | Text |
Enter the license number for the retail agency. Fill only if 'State' requires agent/broker information to be provided.
Depends on:
State
|
| Main Agency Phone Number | Text |
Provide the main phone number for the retail agency. Fill only if 'State' requires agent/broker information to be provided.
Depends on:
State
|
| Second Additional Interest | ||
| Second Additional Interest Name | Text |
Enter the full name of the second additional interest. Fill only if 'General liability' is 'Yes'.
Depends on:
General liability
|
| Second Additional Interest Relationship/Interest | Text |
Provide the relationship or type of interest for the second additional interest, such as 'Additional insured', 'Loss payee', 'Mortgagee', or 'Waiver of Transfer of Rights of Recovery Against Others to Us'. Fill only if 'General liability' is 'Yes'.
Depends on:
General liability
|
| Second Additional Interest Address | Text |
Enter the street address for the second additional interest. Fill only if 'General liability' is 'Yes'.
Depends on:
General liability
|
| Second Additional Interest City, State, Zip Code | Text |
Enter the city, state, and zip code for the second additional interest. Fill only if 'General liability' is 'Yes'.
Depends on:
General liability
|
| Additional Insured (AI) | Radiobutton |
Check this box if the second additional interest should be designated as an additional insured on the policy. Fill only if 'General liability' is 'Yes'.
Depends on:
General liability
|
| Loss Payee (LP) | Radiobutton |
Check this box if the second additional interest should be designated as a loss payee on the policy. Fill only if 'General liability' is 'Yes'.
Depends on:
General liability
|
| Mortgagee (M) | Radiobutton |
Check this box if the second additional interest should be designated as a mortgagee on the policy. Fill only if 'General liability' is 'Yes'.
Depends on:
General liability
|
| Waiver of Transfer of Rights of Recovery (W) | Radiobutton |
Check this box if the policy should include a waiver of transfer of rights of recovery against others to the second additional interest. Fill only if 'General liability' is 'Yes'.
Depends on:
General liability
|
| Second Loss Record | ||
| Second Loss Record - Coverage Type: Property | Radiobutton |
Check this box if the second reported loss was a property loss. Fill only if 'Yes' is 'Yes'.
Depends on:
Yes
|
| Second Loss Record - Coverage Type: Liability | Radiobutton |
Check this box if the second reported loss was a liability loss. Fill only if 'Yes' is 'Yes'.
Depends on:
Yes
|
| Date of Second Loss | Date |
Enter the date when the second loss occurred. Fill only if 'Yes' is 'Yes'.
Depends on:
Yes
|
| Description of Second Loss | Text |
Provide a detailed description of the second loss. Fill only if 'Yes' is 'Yes'.
Depends on:
Yes
|
| Amount Paid for Second Loss | Number |
Enter the total monetary amount that has been paid for the second loss. Fill only if 'Yes' is 'Yes'.
Depends on:
Yes
|
| Amount Reserved for Second Loss | Number |
Enter the total monetary amount that has been reserved for the second loss. Fill only if 'Yes' is 'Yes'.
Depends on:
Yes
|
| Second Loss Record - Status: Open | Radiobutton |
Check this box if the status of the second reported loss is open. Fill only if 'Yes' is 'Yes'.
Depends on:
Yes
|
| Second Loss Record - Status: Closed | Radiobutton |
Check this box if the status of the second reported loss is closed. Fill only if 'Yes' is 'Yes'.
Depends on:
Yes
|
| Specific Project Work Scope | ||
| Yes | Radiobutton |
Check this box if the project scope includes work on airport hangers, antennas, barns, bridges, dams, tunnels, inflatable or bubble buildings, greenhouses, silos, mobile homes, waste water treatment plants, chemical/petroleum/energy/ co-generation facilities, tanks, radio, TV or communication towers, signs, or distribution centers over 100,000 square feet. Fill only if 'Builder's risk/Property' is 'Yes'.
Depends on:
Builder's risk/Property
|
| No | Radiobutton |
Check this box if the project scope does not include work on airport hangers, antennas, barns, bridges, dams, tunnels, inflatable or bubble buildings, greenhouses, silos, mobile homes, waste water treatment plants, chemical/petroleum/energy/ co-generation facilities, tanks, radio, TV or communication towers, signs, or distribution centers over 100,000 square feet. Fill only if 'Builder's risk/Property' is 'Yes'.
Depends on:
Builder's risk/Property
|
| Subcontractor Insurance Requirement Question | ||
| Yes | Radiobutton |
Check this box if certificates of insurance are required for all subcontractors naming the applicant as an additional insured. Fill only if 'No' is 'Yes'.
Depends on:
No
|
| No | Radiobutton |
Check this box if certificates of insurance are not required for all subcontractors naming the applicant as an additional insured. Fill only if 'No' is 'Yes'.
Depends on:
No
|
| Swimming Pool Involvement | ||
| Yes | Radiobutton |
Check this box if there is a swimming pool on the premises or if the project includes the construction or installation of a swimming pool. Fill only if 'General liability' is 'Yes'.
Depends on:
General liability
|
| No | Radiobutton |
Check this box if there is no swimming pool on the premises and the project does not include the construction or installation of a swimming pool. Fill only if 'General liability' is 'Yes'.
Depends on:
General liability
|
| Tandem Crane Lifts/High Value Exposures | ||
| Yes | Radiobutton |
Check this box if the project includes any tandem crane lifts, high values being lifted by a single crane, underground, or waterborne exposures. Fill only if 'Builder's risk/Property' is 'Yes'.
Depends on:
Builder's risk/Property
|
| No | Radiobutton |
Check this box if the project does not include any tandem crane lifts, high values being lifted by a single crane, underground, or waterborne exposures. Fill only if 'Builder's risk/Property' is 'Yes'.
Depends on:
Builder's risk/Property
|
| Third Additional Interest | ||
| Third Additional Interest Name | Text |
Enter the full name of the third additional interest. Fill only if 'General liability' is 'Yes'.
Depends on:
General liability
|
| Third Additional Interest Relationship/Interest | Text |
Enter the relationship or type of interest for the third additional interest. Fill only if 'General liability' is 'Yes'.
Depends on:
General liability
|
| Third Additional Interest Address | Text |
Enter the street address for the third additional interest. Fill only if 'General liability' is 'Yes'.
Depends on:
General liability
|
| Third Additional Interest City, State, Zip Code | Text |
Enter the city, state, and zip code for the third additional interest. Fill only if 'General liability' is 'Yes'.
Depends on:
General liability
|
| Additional Insured | Radiobutton |
Check this box if the third listed additional interest should be designated as an Additional Insured. Fill only if 'General liability' is 'Yes'.
Depends on:
General liability
|
| Loss Payee | Radiobutton |
Check this box if the third listed additional interest should be designated as a Loss Payee. Fill only if 'General liability' is 'Yes'.
Depends on:
General liability
|
| Mortgagee | Radiobutton |
Check this box if the third listed additional interest should be designated as a Mortgagee. Fill only if 'General liability' is 'Yes'.
Depends on:
General liability
|
| Waiver of Transfer of Rights of Recovery | Radiobutton |
Check this box if a Waiver of Transfer of Rights of Recovery Against Others to Us applies to the third listed additional interest. Fill only if 'General liability' is 'Yes'.
Depends on:
General liability
|
| Third Loss Record | ||
| Radiobutton |
Depends on:
Yes
|
|
| Radiobutton |
Depends on:
Yes
|
|
| Third Loss Date of Loss | Date |
Enter the date when the third loss occurred. Fill only if 'Yes' is 'Yes'.
Depends on:
Yes
|
| Third Loss Description | Text |
Provide a detailed description of the third loss event. Fill only if 'Yes' is 'Yes'.
Depends on:
Yes
|
| Third Loss Amount Paid | Number |
Enter the total monetary amount paid for the third loss. Fill only if 'Yes' is 'Yes'.
Depends on:
Yes
|
| Third Loss Amount Reserved | Number |
Enter the total monetary amount reserved for the third loss. Fill only if 'Yes' is 'Yes'.
Depends on:
Yes
|
| Radiobutton |
Depends on:
Yes
|
|
| Radiobutton |
Depends on:
Yes
|
|
| Total Project Cost | ||
| Total Project Cost | Number |
Please enter the total monetary cost of the project, including both labor and material expenses.
|
| Tract Housing Project Status | ||
| Yes | Radiobutton |
Check this box if the project is a tract housing project (five or more structures). Fill only if 'General liability' is 'Yes'.
Depends on:
General liability
|
| No | Radiobutton |
Check this box if the project is not a tract housing project (five or more structures). Fill only if 'General liability' is 'Yes'.
Depends on:
General liability
|
| Underground Tank Operations | ||
| Yes | Radiobutton |
Check this box if there is any construction, installation, renovation, or removal of underground tanks (except residential fuel oil tanks). Fill only if 'General liability' is 'Yes'.
Depends on:
General liability
|
| No | Radiobutton |
Check this box if there is no construction, installation, renovation, or removal of underground tanks (except residential fuel oil tanks). Fill only if 'General liability' is 'Yes'.
Depends on:
General liability
|
| Underpinning/Shoring Involvement | ||
| Yes | Radiobutton |
Check this box if the project involves the underpinning or shoring of adjacent buildings or structures. Fill only if 'General liability' is 'Yes'.
Depends on:
General liability
|
| No | Radiobutton |
Check this box if the project does not involve the underpinning or shoring of adjacent buildings or structures. Fill only if 'General liability' is 'Yes'.
Depends on:
General liability
|
| Watchman on Premises Question | ||
| Yes | Radiobutton |
Check this box if a watchman will be on premises during non-working hours.
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| No | Radiobutton |
Check this box if a watchman will not be on premises during non-working hours.
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| Work Performed by Applicant | ||
| Percentage of Work | Number |
Provide the percentage of the total project work that will be performed directly by the applicant, their employees, or volunteers.
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