You can also call us to get a quote by phone or to have any of your questions answered
888-900-9989
Day(s) Hours
Monday - Thursday 7:00 a.m. - 7:00 p.m.
Friday 7:00 a.m. - 5:00 p.m.
  • Covers a building under construction
  • Usually written for a specified amount and only applies during the course of construction
  • May also cover items stored at work site
  • Often requested by bank providing construction loan for new home and remodel work
More Info >>

 

Business Name  Quote Needed By
   
Owners Name  Years Of Exp.
 
Address (No P.O. Box)
City  State  Zip  County
     
 Phone Number  Fax Number  Cell/Pager Number
   
Active E-mail Address
Preferred Method Of Contact
    Mail:    Fax:    Phone:    E-mail:  
Lic. # or App. Fee # Classification Entity (check one)

Partnership
Sole Owner
Corporation
Are you the Contractor, Owner Builder, or Developer?   
Have you been cancelled or non-renewed by any previous insurance carrier for underwriting or premium payment reasons?
(If the carrier pulled out of the market, please answer no)		 Have you filed bankruptcy in the past 7 years?
Yes  No  Yes  No 
CONTRACTOR
General Contractor's Name  Contractor's License Number  State
   
LOSS HISTORY for BUILDERS RISK (PAST 3 YEARS)
If any (Explain losses below or if none put none)		  Have you finished similar jobs?
 Yes  No 
CONSTRUCTION JOBSITE LOCATION
Site Address State
 
City  Zip  Distance to the Fire Department
   
Are there fire hydrants on the property?  Yes  No 
Is there a Security Watchman at site during off hours?  Yes  No 
Other Security: (Lighting, Fencing, Alarms etc.)  
PROJECT INFORMATION
If more than one, explain in the Description of project
Construction Type  Number Of
 Stories 		 Limit of insurance at Construction
 Jobsite Location
    
Construction
Start Date		  Desired
 Effective Date		  Desired
 Expiration Date		  Occupancy of Building
 when finished
         
Deductible  Fire Protection
 Class 		 Will construction/renovation have started more than 30 days prior to the proposed effective date of the policy?
 
 Yes  No 
Is project to be done in phases?    If yes, what is being done in each phase 
Yes  No 
  
Is this project a Renovation or Addition to an existing structure?   If yes, please enter optional coverages, deductibles, forms etc.
Yes  No 
  
Description of project (be detailed please) information
How did you hear about Skyles Insurance Agency?
    Construction Services    Economy Bonds Mail Flyer
    Post Card Friend Already a Customer
    Web Search Phonebook    
    Other:  
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