Snow Removal Contractors Questionnaire Template - Anderson Mctague & Associates Page 2
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210. Does the operator keep a log of jobs done including why the applicant went to the job, when the applicant arrives
and when they finished? If yes, please provide a copy.
11. Does the Insured subcontract any snow removal to others?
•
Does the applicant obtain certificates of insurance?
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Does the applicant insist on matching or better CGL limits than the applicant carries?
•
Is the applicant added to the subcontractor’s CGL policy as an additional insured?
12. How many snow removal/clearing vehicles does the applicant own?
13. How many employees does the applicant have?
14. Is this part time work?
•
If so, what does the applicant do full time?
•
During the off-season?
15. Does the applicant enter into municipal contracts?
16. Does the Insured do any snow removal or clearing of any areas used by aircraft?
Estimated Annual Revenue:
Limit of Liability Requested:
$1,000,000
$2,000,000
Estimated Annual Payroll:
$3,000,000
$5,000,000
Current Insurer & Policy Number:
LOSS HISTORY – PROVIDE FULL DETAILS (IF NONE, PLEASE INDICATE BELOW)
I may have provided personal information in this document and by other means and I may in the future provide further personal information. Some
of this personal information may include, but is not limited to, my credit information and claims history. I authorize my broker or insurance
company to collect, use and disclose any of this personal information, subject to the law and to my broker’s or insurance company’s policy
regarding personal information, for the purposes of communicating with me, assessing my application for insurance and underwriting my policies,
evaluating claims, detecting and preventing fraud, and analyzing business results. I confirm that all individuals whose personal information is
contained in this document have authorized that I agree to the above on their behalf.
Applicant’s Signature:
Date:
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Parent category: Life