Workers Compensation Application Page 3
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424.
LIST ANNUAL PAYROLL SEPARATELY BY STATE CATEGORY
(Include independent contractors payroll not
covered by other insurance)
A. OFFICE AND MANAGEMENT
CATEGORY
UNARMED
ARMED
CATEGORY
UNARMED
ARMED
Executive
Sales
Supervisory
Clerical
B. GUARD SERVICES
CATEGORY
UNARMED
ARMED
CATEGORY
UNARMED
ARMED
Airports
Mid/High Income Housing
Apartments/Condos
Movies/Theaters
Armored Cars
Museums/Galleries
Parking Garages/Lots/Toll
Auto Dealerships
Collectors
Patrol Cars (describe)
Banks/Office Buildings
Bars/Nightclubs/Liquor
Stores
Bodyguard/Executive
Rehab Institutions
Protection
Bus/Train Terminals
Restaurants
Colleges/Universities
Retail/Grocery Stores
Concerts
Security Consultation
Construction Sites
Shopping Malls
Conventions/Trade Shows
Social Services/Clinics
Special Events (describe)
Courier/Escort
Fast Food Establishments
Sporting Events (describe)
Gated Communities
Golf/Tennis/Yacht Clubs
Government Contracts*
Strike Duty
High Schools
Traffic Control
Hospitals
Trucking Terminals
Waterfront/Piers/Marinas/
Hotels/Motels
Crew Members
Industrial (Factories,
Other (describe):
no abbreviations
Warehouses, etc.)
Low Income Housing
* Please attach scheduled location/list of government contracts.
C. PRIVATE INVESTIGATION
CATEGORY
UNARMED
ARMED
CATEGORY
UNARMED
ARMED
Credit or Pre-Employment
Insurance/Legal
Domestic
Undercover
Auto Repossessions
Shopping Service
Psychological Stress
Lie Detection
Evaluator
Paper and Pencil
Drug Testing
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Parent category: Legal