General Liability Quote | Jaikar Insurance Services

1 What Do You Do & Where?

Business Name Business Address, City, ZIP Exact Work You Do? (e.g. Handyman, Janitorial, Plumbing, Salon)

Are you a Licensed Contractor?

Yes No

CA Contractors License # (CSLB) Do you need GL for License / City / Contract?

Years in Business

Entity

LLC Corp Sole Prop Partnership

Annual Gross Sales $ Number of Employees (incl. owner) Estimated Annual Payroll $

Do you hire Sub-Contractors?

Yes No

Do they have insurance & give you COI?

Yes No

Cost of Subs $ per year

Work at heights over 2 stories?

Yes No

Do you do Roofing, Excavation, New Construction?

Yes No

Do you Rent or Own location?

Rent Own

Sq Ft

Any Claims / Losses Last 3 Years?

Yes No

Explain

Standard $1M / $2M or higher?

$1M / $2M $2M / $4M Other $

Does contract / building / city require higher or WOS?

Current Insurance Company & Premium

Any Lapse / Cancellation?

Yes No

Effective Date Needed

Need COI Today for Job / Lease / License?

Yes No

Name (Required) Phone (Required)

Email (Required)