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Home > Contractors Insurance > Homebuilder Questionnaire
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Homebuilder Questionnaire


Fill out the following form as completely as possible. Once you have completed the form, click the Submit button to send your information. Your request will be handled promptly.

Company Information
Company Name *
Street *
City *
State *
ZIP / Postal Code *
E-Mail Address *
Primary Phone Number *
Alternate Phone Number
Contact Name
Company Owner
First Name *
Last Name *
Nature of Business
Years of Experience
Number of Owners
Gross Annual Sales
Number of Employees
Annual Employee Payroll
Subcontractors Used
Annual Cost of Subcontractors
Additional Information
Prior Insurance
Length of Coverage (Months and Years)
How many additional insureds are required?
How did you hear about us?
Counties of Operation
Do you act as a Sub Superintendent or Project Manager for Other Builders?
Do you do any Commercial Construction
Average Gross Receipts from Commercial Work
Describe typical projects:
Do you require subcontractors to carry General Liability insurance?
Do you require all subs to carry Workers Comp?
Do you have written contracts with your subs?
Do you offer a Warranty outside of the standard One Year Builder Warranty?
Current General Liability Insurer:
Current Workers Compensation Insurer
Current Builders Risk Insurer
Claims/Property Losses in Past 5 Years (Please Explain)
Homebuilders Information
Number of Homes Projected in the next 12 months
Average Price Range
Do you Build



Developers (Optional)
Do you develop lots?
If yes, do you sell to other builders or build homes yourself?
Any Vacant Land/Real Estate Development Property owned by the company?
If Yes, how many acres?
Remodeling Information (Optional)
Number of projects per year
Describe typical projects:
Average hard cost
Submission Validation
Required

Important Notice
Any submissions or payments made via this website do not constitute a binding agreement to your policy or coverages. Changes and payments to policies are not effective or binding until you, or any party involved, receive official notice from either your insurance agent, or your insurance company. If you have any questions, please feel free to contact us.

Per the terms of our online privacy policy we will not resell your information to any third-party.
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