Hendrickson Insurance · Sarasota, Florida

Contractor & trades application.

General liability, tools and equipment, and workers comp for Gulf Coast contractors and trades — Sarasota, Bradenton, Tampa, and St. Petersburg. Florida underwriters price this off your trade, your payroll, and how you use subcontractors, so the more accurate you are here, the tighter the quote. Estimates are fine where you are not sure.

A. Business & Contact

Legal / named insured (business name) *

Required.

DBA (if any)

Contact name *

Required.

Business address

City

State

ZIP

Business phone *

Required.

Email *

Enter a valid email.

Entity type

Years in business

State license #

B. Trade & Operations

Primary trade *

Required.

Describe the work you do

% residential

% commercial

% new construction vs service/repair

Jobsite radius

Largest single job (past 3 yrs)

C. Size & Payroll

Annual gross receipts

Annual payroll (W-2)

# of owners

Full-time employees

Part-time / seasonal

Do owners want to be covered by WC?

D. Subcontractors

How you use subs is the single biggest driver of a contractor's GL and workers comp cost. Uninsured subs get added back to your payroll at audit, so this matters.

Annual cost of subcontracted work

What work do you sub out?

Do you collect certificates of insurance from every sub?

E. Property, Tools & Equipment

Business location

Building value (if owned)

Business personal property (office/shop contents)

Tools & equipment value (inland marine)

F. Coverage Wanted & Current Insurance

Check what you want quoted

Current carrier (if any)

Current policy expires

G. Loss History

List date, type, and amount for each

H. Acknowledgement

I certify the information above is true and complete to the best of my knowledge. Submitting this form does not bind coverage; coverage is subject to underwriting approval and payment of premium.

Typed signature (full name) *

Required.

Date *

Required.

I agree to the statement above. *

Please confirm to submit.

Back

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Thank you — application received

Dennis will review it and follow up shortly with your quote. Questions? Call or text 941-952-7991.

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