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Business Underwriting Information
Carrier/# of years
Type of Operation
Years in business
Describe operations in detail
Limit of Liability Coverage Requested
(Describe claims in detail including amounts paid. If no claims leave blank)
Number of Active Owners
Number of Employees
Annual Employee Payroll
Annual Gross Sales
Average Job Size
Years experience in field
Percentage of work
Do you subcontract work?
If yes, what %?
Do you currently have a Safety Program?
Please explain all other data in the space below and any other information you feel
would be pertinent to your quote.
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