Handyman Insurance Application

COLONY SPECIALTY INSURANCE
HANDYMAN SUPPLEMENTAL APPLICATION

Insured: Date:

APPLICATION INFORMATION

Owner/Partner (16,000 ea.): $ Subcontractor Cost: $ (Prohibited)

Employee Payroll: $ Total Payroll: $ ($50,000 max)

Uninsured Subcontractor Payroll: $ Total Receipts: $ ($100,000 max)

(submit if payroll or receipts are greater than our max amount)

Leased Employee Payroll: $ Number of Employees:

Years in business: Years of Experience:

Are you licensed? Yes No Types of Licenses Held:

Have you ever been or are you involved in any new residential construction of tract homes, condos, apartments, town homes or custom homes?

Have you ever been or are you involved in the construction of residential room additions?

Risk is a (% of each): Roofing % (if any Roofing, then refer to our Roofers PDQ for guidelines. Incidental roofing requires a separate Roofing code and minimum premium)

CONTRACTORS QUESTIONAIRE

Describe types of repair work done:

List the last 5 jobs including the cost of those jobs.

Explain types of work performed by all insured and uninsured subcontract labor.

Are certificates of insurance obtained prior to subcontractors starting work? Yes No

Minimum Limits Required $

Maximum number of stories:

Describe any losses:

I hereby certify that all information is accurate to the best of my knowledge.