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A copy of your current
insurance policies, including Workers’
Comp, premium calculation page(s). |
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Five years loss runs for
all lines of coverage. (General Liability,
Workers’ Compensation, Auto, as
well as Property & Marine, if any). |
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Three years Workers’
Compensation Experience Mod. Worksheets.
The Bureau requires a Letter of Authority
on your letterhead to release this information.
We can provide you with a sample letter
with the required wording upon request. |
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Copy of your two most
recent final payroll audits from your
General Liability and Workers’
Compensation carriers. |
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Financial statements for
the most recent year-end. |
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Proposed payroll and receipts for
the coming year. |
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Current schedule of automobiles &
contractors equipment from policy or
by separate listing. |
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List of drivers with birth dates and
license numbers. |
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Building size, type and year of construction,
use/occupancy/tenants (by %), fire protection,
exposed buildings within 100 ft for
your office location; and for any other
locations to be insured for Building
or Contents. |
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A list of your current jobs, and five
largest jobs in the past 5 years (name
and contract amount). |
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Indicate the average number of jobs
typically completed during the course
of a year. |
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Copy of Subcontract Agreement used
with subcontractors |
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Copy of table of contents of your
Safety Program, if any. |
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