General Underwriting |
1. Desired Policy Effective Date |
|
2. Limit of Liability Desired:
$ 300,000/Occurrence
$ 500,000/Occurrence
$ 1,000,000/Occurrence |
3. General Liability Deductible: ($ 1,000 minimum
deductible): |
4. Prior Insurance Carrier:
Last Year's Sales:$ |
5. How Long have you been in business?
Years |
Have there been any changes in ownership, name or business operations in the last three (3) years? If yes explain....
|
Yes
|
No |
6. Is the owner active in the business? |
Yes
|
No
|
7. List Your three largest clients:
|
8. Breakdown of your clients............. |
Commercial
%
|
Residential
%
|
9. Are you a member of the Pest Control Association? |
Yes
|
No
|
10. Do you engage in any business other than Pest Control?
If Yes, please describe:
|
Yes
|
No
|
11. Do you engage in any drilling operations as regards to pesticide applications? |
Yes
|
No
|
12. Are warnings posted prior to work performed? |
Yes
|
No
|
13. How long do you maintain records on work performed? |
Yes
|
No
|
14. Describe procedures used to ensure sub-contractors are adequately insured and supply proof of insurance
|
15. Do you provide WDO / WDI inspections?
a) Average amount of time spent
performing a pest inspection.......:
HH:MM
b) Number of inspections done
annually for real estate closings.....: |
Yes
|
No
|
16. Have you ever performed treatments or inspections to homes constructed
with any type of exterior insulation finishing systems or synthetic stucco
system?
If Yes, approximately how many homes: |
Yes
|
No
|
17. If Termite baiting systems are used, please complete the following:
a. Brand of baiting system.........:
b. Are customers told or given written
guidelines explaining the time frame between bait transfer an colony elimination?
c. Are technicians trained by a system
manufacturer as to the use of the baiting system?
If No, what
type of training do technicians receive:
d. If there a written log to confirm
that the technician acted in accordance with the manufacturer specifications
on all accounts? |
Yes
Yes
Yes
|
No
No
No
|
18. List chemicals normally used: |
19. Do you mix chemicals of others and place their labels on them? |
Yes
|
No
|
20. Do you engage in retail sales of chemicals? |
Yes
|
No
|
21. Are chemicals stored and handled as received from the manufacturer?
If NO, what alterations are
made prior to sale? |
Yes
|
No
|
22. How Are Chemicals Stored?
Above ground tanks
Underground Tanks
If Other, please describe: |
23. Are premises controlled regarding access to chemical storage areas? |
Yes
|
No
|
24. Are chemicals stored in manufacture's containers in a separate
building?
If Yes, describe building: |
Yes
|
No
|
25. Describe precautions used to secure chemicals at your
business...:
What is the maximum volume of chemicals
stored at your location: |
26. Describe precautions used to secure chemicals at customer's
locations....:
What is the maximum volume of chemicals
stored at customer's locations: |
27. What is the radius of transportation of chemicals: |
28. How many vehicles are used to transport chemicals? |
29. What is the maximum volume stored in any one vehicle? |
30. Describe the method of securing chemical containers
while in transit? |
31. Do you have a standard operating procedure for containment of chemicals
in the event of an auto collision or overturn vehicle?
If Yes, please explain: |
Yes
|
No
|
PERSONNEL & TRAINING
|
32. Home many employees (excluding owners) are employed?
Clerical:
Technicians:
Sales:
|
33. What training is provided for non-certified employees? |
|
|
34. Does training programs include a minimum of four (4) weeks of on-the-job
training with a supervisor? |
Yes
|
No
|
35. Are new employees supervised until training is complete? |
Yes
|
No
|
SALES & PAYROLL
|
36. What are your gross annual sales: $ |