Strickland Insurance Brokers

Online Quote - Full Quote

*Complete and submit the form below and an underwriter will contact you as soon as possible with a quote.

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Agency Code

Agency

Agent Name

Agent Email

Insured's Name

Doing Business As Name

Address:

City:

State:

Zip:

Insured's Experience

Employee Payroll ($)

Number of Owners

Gross Receipts ($)

Are subcontractors used?

Subcontractor Annual Cost ($)

What percentage of work is being contracted out?

Will subcontractors be required to carry equal or greater limits of general liability insurance?

Will subcontractors be required to name our applicant as an additional insured on their policies?

Will subcontractors be required to have a Hold Harmless Agreement in place in favor of our insured?

Will all work be performed in NC?

In what other states will the insured operate?

Prior Coverage

Is this a New Venture or has coverage never been required?

Cancelled or Non-renewed

For what reason was the policy Cancelled or Non-renewed?

Explain:

Has this insured ever had coverage placed through SIB?

Most recent SIB policy number:

Any losses within the last three (3) years?

Dollar amount paid out on loss(es):

Provide a brief description of loss(es):

Effective Date Requested: (mm/dd/yyyy)

Coverage Limit Requested:

Class / Operation 1

Class / Operation 2

Class / Operation 3

Percentage of Total Operation

Percentages must total 100%

Each field must have a value greater than 0%

Carpentry

Interior or Exterior?

Percent Interior:

Percent Exterior:

Percentages must total 100%

Residential or Commercial?

Percent Residential:

Percent Commercial:

Percentages must total 100%

New Construction or Repair?

Percent New Construction:

Percent Repair:

Percentages must total 100%

Any work on Tract Homes?

Any work over three (3) stories?

Any Tile, Slate, Marble, Mosaic, or Terrazzo work?

Floor Covering Installation

Any Ceramic, Tile, or Stone work?

Any Hardwood Flooring?

Does insured do Sanding and Finishing work?

How does insured dispose of rags used for Sanding and Finishing?

HVAC

Any work with LP Gas?

Any work on Wood, Coal, and/or Oil Burning Stoves?

Any fireplace insert work performed?

Janitorial

Number of Full-Time Employees

Number of Part-Time Employees

Any floor waxing, carpet shampooing, and/or exterior window washing?

Percentage of Floor Waxing:

Percentage of Carpet Shampooing:

Percentage of Exterior Window Cleaning:

Masonry

Any foundation and/or underpinning repair work?

Paint

Interior or Exterior?

Percent Interior:

Percent Exterior:

Percentages must total 100%

Does the insured use sprayers?

Plumbing

Residential or Commercial?

Percent Residential:

Percent Commercial:

Percentages must total 100%

Does the insured repair and/or test backflow valves?

Does the insured work on commercial boilers?

Remodeling

Residential or Commercial?

Percent Residential:

Percent Commercial:

Percentages must total 100%

Any roofing, HVAC, plumbing, and/or electrical work performed?

Percent Roofing:

Percent HVAC:

Percent Plumbing:

Percent Electrical:

Any painting work performed?

Does the insured use sprayers?

Roofing

Residential or Commercial?

Percent Residential:

Percent Commercial:

Percentages must total 100%

Any hot tar and/or heat application being used?

Any work over three (3) stories?

Siding Installation

Percent of Vinyl Siding installed:

Percent of Hardiplank / Hardiboard Siding installed:

Percent of Cedar Siding installed:

Percent of Metal Siding installed:

Percent of "Other" Siding installed:

List "Other" Siding used.

Percentages must total 100%

Trucking

Is Auto Liability coverage in place at equal or greater limits?

Is the policy / quote with Strickland Insurance Brokers' Transportation Department?

What commodities are hauled?

List "Other" commodities hauled.

Give us a call: (919) 429-3028

*Complete and submit the form below and an underwriter will contact you as soon as possible with a quote.

This page will only work if Javascript is enabled on your browser.

Percentage of Total Operation

Carpentry

Floor Covering Installation

HVAC

Janitorial

Masonry

Paint

Plumbing

Remodeling

Roofing

Siding Installation

Trucking