Prefabricated Building Erection Insurance

Insurance for Contractors erecting Prefabricated Building Insurance is available in all States. Contractors that purchased this type of insurance may also purchase Commercial Auto, Workers Compensation, Tool Coverage, Bond and Life Insurance.

1State(s) and Type

- SELECT ALL STATES OF OPERATION
  Select all of the States you are or will be operating in during the next twelve months of operation.
- Requested Effective Date
  MM slash DD slash YYYY
- - AL
  - AK
  - AZ
  - AR
  - CA
  - CO
  - CT
  - DC
  - DE
  - FL
  - GA
  - HI
  - ID
- - IL
  - IN
  - IA
  - KS
  - KY
  - LA
  - ME
  - MD
  - MS
  - MC
  - MN
  - MI
- - MO
  - MT
  - NE
  - NV
  - NH
  - NJ
  - JM
  - NM
  - NY
  - NC
  - ND
  - OH
- - OK
  - OR
  - PA
  - RI
  - SC
  - SD
  - TN
  - TX
  - UT
  - VT
  - VA
  - WA
- - WV
  - WI
  - WY
- CHECK THE BOXES FOR WHICH YOU WANT TO RECEIVE A QUOTE
  It is vital that you now order your "hard copy loss runs" from your current and prior insurance carrier. This is a common practice and it is required. Please order them now if you have not done so.
- WHICH TYPES OF INSURANCE DO YOU WANT TO RECEIVE A QUOTE ON?
  We understand this may require some time to gather the information. You have the "option" use a "save and return feature." Register and begin the process. Then, if you need to you can return, login and finish your application. Your information is safe, encrypted and deleted after 29 days.
  - General Liability Insurance
  - Inland Marine / Took Coverage
  - Business Auto Insurance
  - Workers Compensation
  - Contractor Bond
  - Life Insurance

Note: In order to use this save and continue feature please register first. If you are not registered DO NOT attempt to use this save and continue feature. Please call 209 223-1870 to let us know when you registered as we must manually approve your registration. "Save and Continue feature" will allow you 29 days to complete your forms. After that time all form data will be removed. All data is encrypted and secure.

- GENERAL LIABILITY
- 125
- Name
  First Last
- Business Name
- Mailing Address
  Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
- Business Formation Type
- Phone
- Fax
- Email
  Enter Email Confirm Email
- Website
- Business "Physical" Location(s)
  All locations owned, leased or rented
- How many offices and location do you have?
  All locations must be declared
- LOCATION 1
- Location 1 Address
  Street Address Address Line 2 City State ZIP Code
- Interest - Occupy as Owner or Tenant?
  - Owner
  - Tenant
- # Full Time Employees
- # Part-Time Employees
- Est. Annual Revenue This location
- Open to Public?
- Total Building Square Footage
- LOCATION 2
- Location 2 Address
  Street Address Address Line 2 City State ZIP Code
- LOCATION 3
- Location 3 Address
  Street Address Address Line 2 City State ZIP Code
- LOCATION 4
- Location 4 Address
  Street Address Address Line 2 City State ZIP Code
- LOCATION 5
- Location 5 Address
  Street Address Address Line 2 City State ZIP Code
- LOCATION 6
- Location 6 Address
  Street Address Address Line 2 City State ZIP Code
- LOCATION 7
- Location 7 Address
  Street Address Address Line 2 City State ZIP Code
- LOCATION 8
- Location 8 Address
  Street Address Address Line 2 City State ZIP Code
- LOCATION 9
- Location 9 Address
  Street Address Address Line 2 City State ZIP Code
- LOCATION 10
- Location 10 Address
  Street Address Address Line 2 City State ZIP Code
- If you have additional office please list them here
- 126

- INLAND MARINE 152

- BUSINESS AUTO
- Commercial Auto
  - Commercial Auto
  From individual vehicles to fleet. Optional endorsements for Hired, non-owed, drive other car, additional insured. Let's talk about it.

- WORKERS COMPENSATION 130

- CONTRATOR BOND

- INDIVIDUAL, BUSINESS OR GROUP LIFE
- Life Insurance
  - Individual and Family Life Protection
  - Key Personal Insurance
  - Buy & Sell Insurance

Prefabricated Building Erection Insurance

SELECT ALL STATES OF OPERATION

CHECK THE BOXES FOR WHICH YOU WANT TO RECEIVE A QUOTE

GENERAL LIABILITY

125

Business "Physical" Location(s)

LOCATION 1

LOCATION 2

LOCATION 3

LOCATION 4

LOCATION 5

LOCATION 6

LOCATION 7

LOCATION 8

LOCATION 9

LOCATION 10

126

INLAND MARINE 152

BUSINESS AUTO

WORKERS COMPENSATION 130

CONTRATOR BOND

INDIVIDUAL, BUSINESS OR GROUP LIFE