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General Liability Application

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general-liability-application.pdf


Application date
Mar 22, 2024

Application number

GL-APP-2024-123456


Business name

Premier Construction Services Inc.


Dba

Premier Builders


Business address

2500 Contractor Lane, Denver, CO 80201


Mailing address

PO Box 2500, Denver, CO 80202


Business phone

(303) 555-0678


Business email

insurance@premierbuilders.com


Fein

84-1234567


Business type

Corporation


Date established
Jun 15, 2010

Nature of operations

General contractor - commercial and residential construction


Sic code

1522


Naics code

236220


Annual gross receipts

8,500,000


Annual payroll

2,200,000


Number of employees

35


Subcontractor costs

3,000,000


Coverage requested

Each occurrence

1,000,000


General aggregate

2,000,000


Products completed ops

2,000,000


Personal advertising injury

1,000,000


Damage to rented premises

100,000


Medical expense

10,000


Additional coverages
3 items
Value

Blanket Additional Insured

Waiver of Subrogation

Primary Non-Contributory


Work performed
3 items
DescriptionPercentage

Commercial construction

60

Residential construction

30

Remodeling

10


Geographic area

Colorado


Prior carrier

Contractors Insurance Co


Prior policy number

GL-2023-789012


Current premium

35,000


Claims last 5 years

1

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Connect General Liability Applications across your stack

DocuPipe captures general liability applications from brokers, agents, or online submissions. Extract business classifications, payroll data, and revenue information, then route to commercial underwriting for risk assessment and rating.

Sources
Email
C
Claims Portal
A
Agent Portal
Cloud Storage
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Destinations
P
Policy Admin
C
Claims System
U
Underwriting
API

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Your business has specific documents with your own rules of how you need to understand them and act on them. Define exactly what you need to extract, reliably, for any layout and language.

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