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Contractor Survey – Hutch

Contractor Survey – Hutch

Business

Contact name:
Address:
Other location(s):
MM slash DD slash YYYY
List
Employee List (including owner)
Job Duties
Full or Part Time?
Payroll
Driver of Company Vehicles?
 
List
List Last Five Jobs Completed:
Job Done For:
% Subcontracted:
 
List
Subcontractors Used:
Job Duties:
Cost:
Certificate of Insurance?
 

General Liability Limit

Property

Physical address:
List other tenants:

Workers’ Compensation

MM slash DD slash YYYY
List
Class code #:
Payroll =
 
(check all that apply)

Autos

If no, consider adding the corporate officers named coverage endorsement.
List
Year
Make
Model
VIN
 

Company

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