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Contractor Intake

General Liability Submission

Complete your request in a few guided steps.

Step 1 of 5 20%
Business
1 Business
2 Work Mix
3 Receipts & Employees
4 Coverage
5 Review

Referral, license, and business information

Start with how you heard about us, then use the license lookup to prefill what we can.

Optional — if found, we will prefill available business and mailing information.
Tip: Use your CSLB license number to prefill business name, phone, and mailing address options.
License found
Company: —
License #: —
Type: —
License not found. You can still continue by filling the form manually.

Work performed and occupancy

Start with commercial vs residential, then break down the kind of work you perform.

Commercial vs Residential
Commercial % and Residential % should total 100%.
Type of Work Performed
ⓘ
Service & Repair %, Remodel %, and New Construction % should total 100%.
New Construction Details
What counts as new construction?
Building from the ground up before certificate of occupancy is issued.

Receipts and employees

Enter annual receipts, subcontractor costs, employee count, and approximate payroll.

$
$
If you don't have any employees, please enter 0.
If you don't have any employees, please enter 0.
$

Coverage

Select your desired policy limits and optional umbrella amount.

Review your submission

Please confirm the information before sending your request.

Referral Source
—
License Number
—
Business Name
—
Business Type
—
Main Contact Name
—
Email Address
—
Phone Number
—
Mailing Address
—
Description of Operations
—
Commercial %
—
Residential %
—
Service & Repair %
—
Remodel %
—
New Construction %
—
New Construction Type
—
Annual Gross Sales
—
Subcontractor Costs
—
Number of Full-Time Employees
—
Number of Part-Time Employees
—
Approximate Annual Payroll
—
Desired Policy Limits
—
Umbrella Needed
—
Umbrella Amount
—
Claims in Past 5 Years
—
Claims Details
—
Verification
Please verify before submitting your general liability request.