Audit Submit Online This is an audit for your policy to verify accuracy of information.Company Name* Policy Number* Detailed Description of Operations:*# Of Employees (Excluding Owner)* Gross Payroll (Excluding Owner) $* Number of Projects or Homes Started:* Number of Projects or Homes Completed:* Gross Receipts:* Please select the appropriate operations that describe your work:*A/C RefrigerationA/C System InstallationAppliance & Accessories InstallationCarpentry ExteriorCarpentry InteriorCleaning (Outside Building)Concrete (Flat)Concrete FoundationDrillingDebris RemovalDoor/Window InstallationDrywallElectricalExcavationFencingFloor Covering InstallationGarage Door InstallationGeneral Contractor New ResidentialGeneral Contractor New CommercialGlass Installation/GlazingGradingHandymanHVACInsulationJanitorialLandscapeMasonryMetal Erection (Decoration Only)Painting InteriorPainting ExteriorPlastering/StuccoPlumbingPressure WashingRemodel Contractor ResidentialRemodel Contractor CommercialRoofingSeptic Tank Install & ServiceSheet MetalSiding and DeckingStreet/Road Paving (Commercial)Swimming Pool CleaningSwimming Pool InstallationTile & Marble InstallationTree TrimmingWater DrillingWelding (Non-Structural Only)Other:To select multiple classes hold down the Ctrl key while selecting.Other operations - please clarify:* Excavation - please clarify how many feet down?* Do you use Subcontractors?*YesNoDollar Amount of Work Subcontracted:* What minimum General Liability limit is required?* Do the subcontractor(s) provide certificates of insurance?*YesNoDo you provide supervision for the subcontractors?*YesNoDo you have a written contract agreement with the subcontractor(s)?*YesNoIf so, is there a “Hold Harmless” clause in your favor in the contract?YesNoDo you always require subcontractor(s) to name you as additional insured?*YesNoType of Work & Job OperationsPercent of Remodeling / Service / Repair:* Percent of New Construction:* Percent of Commercial Construction:* Percent of Residential Construction:* Check all boxes that apply to your business:* Condo Track Homes Commercial Roofing Town- Home Single Family Homes Industrial Home Owners Association Other Residential Other, please specify: Other, please specify:****IMPORTANT*** PLEASE SUBMIT THE FOLLOWING REQUIRED DOCUMENTATION FOR THE POLICY TERM: Profit & Loss Statement ( ); OR Bank Statements ( ) These documents should summarize your revenue, costs and expenses incurred during the policy period. Drop files here or Select files Accepted file types: jpg, gif, png, pdf, Max. file size: 512 MB. Audit Completed by:* Date:* MM slash DD slash YYYY Email address:* Contractor’s License Number (If Applicable): By submitting the audit, I am confirming that all information included is accurate, official and not forged. I Agree PhoneThis field is for validation purposes and should be left unchanged.
