Contractors Insurance Quote

A member of the Pacheco Insurance staff will personally develop a quote suited to your particular insurance needs. We value our customers and take pride in the personal attention we provide.

Contact Information

Your Full Name *

Email *

Cell Phone

Day Time Phone

Fax

Street Address

City

State

Zip Code

General Information

Organization Type

Please describe.

Any operation or property that is owned, leased or occupied that is not covered by this policy?

Yes

Please describe.

Do you perform more than 10% of your work in a state other than your state of domicile?

Yes

Please describe.

Total number of employees including Owners Officers/Partners

Total number of employees

Not including Owners/Officers/Partners

Total payroll

Number of years experience

Not including Owners/Officers/Partners

Percentage of work performed within 50 miles of your base of operations:

Amount of sales receipts for current year

Amount of sales receipts for prior year

Percentage of work which is residential

Percentage of work which is commercial

Complete if Residential or Remodeler Contractor

Skip Section

Do you require to be named as an Additional Insured on the subcontractor's policy?

Yes

Please explain

Do you ever act as a Construction Manager?

Yes

Annual fees

Description

General Liability - Complete if Trade Contractor

Skip Section

Do you have any owned autos?

Yes

Please describe.

Do operations include tunneling or trenching work deeper than 3 feet?

Yes

Please describe.

Do you contact utility services prior to digging or working with overhead wires?

Yes

Please describe.

Do you perform dam or levee work or have you done so in the last 10 years?

Yes

Please describe.

Do you perform work at landfill sites or have you done so in the last 10 years?

Yes

Please describe.

Do you perform any railroad track/trackbed construction, repair or maintenance or have you done so in the last 10 years?

Yes

Please describe.

Do you install any automatic sprinkler or fire suppression systems or have you done so in the last 10 years?

Yes

Please describe.

Do you install fire alarms or smoke detectors or have you done so in the last 10 years?

Yes

Please describe.

Do you install or repair gas mains (excluding hose connections) or have you done so in the last 10 years?

Yes

Please describe.

Do you install, service or repair high pressure boiler systems or have you done so in the last 10 years?

Yes

Please describe.

Do you apply "Exterior Insulation Finish Systems"(a/k/a "Synthetic Stucco") or have you ever done so in the past?

Yes

Please describe.

Any remodeling involving foundation, structural changes or movement of load bearing walls?

Yes

Please describe.

Minimum General Liability limits required of subcontractors:

Per Occurrence

Minimum General Liability limits required of subcontractors:

Aggregate

Contractors Equipment - Complete if requesting this coverage

Skip Section

Any Mobile Equipment?

Yes

Please complete below.

Does operator have less than 2 years experience in operating the equipment?

Yes

Please comment.

Does this mobile equipment have any maintenance program in place?

Yes

Please describe.

Is equipment secured and protected when not in use?

Yes

Please describe.

Response Method

I would like my quote sent to me via

Telephone

Text Message

How did you hear about us?

Questions or Comments

Sign up for text messages

By submitting this form and signing up for texts by checking the box below, I agree to receive conversational text messages from Pacheco Insurance Agency, Inc. using the contact information provided. For help upon receiving a text message from us, reply HELP. To opt-out of receiving text messages at any time reply STOP. Message and data rates may apply. Message frequency varies. Please view our Privacy Policy at https://www.pachecoinsurance.net/privacy-policy/.

Yes, I agree

reCAPTCHA is required.

Business Contractors Quote