Name: Sunshine Insurance Group
Price range: $$

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Legal Business Name*

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Business Address*

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Estimated annual Gross Receipts this year*

(all the money you bring into the bank account before paying anything out)

Estimated annual Gross Payments to Residential Subcontractors this year*

Estimated annual Gross Payments to Commercial Subcontractors this year*

Do you obtain signed Subcontractor Agreements and Certificates of Insurance with your company name listed as Additional Insured?*

Yes

Do you use any Uninsured Subcontractors?*

Yes

What type of work to uninsured subcontractors perform and how much do you pay them?*

Please provide a description of your scope of work*

Any additional details you think we need to know?

All the above information is accurate and true to the best of my knowledge*

Yes

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