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Built Insurance Brokerage
805-413-4331
About
Resources
Blog
Quote
Request Cert
Contact
Make a Payment
Call us today!
805-413-4331
Built Insurance Brokerage
Quote
Request Cert
Contact
Make a Payment
Contractors Rater
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Contractor License #*
Name of Business*
Applicant Name*
E-Mail Address*
Phone Number*
Address*
City*
Zipcode*
Legal Structure*
Sole Proprietor
LLC
Corporation
Years In Business*
Classifications and Payroll (4 Max)
Carpentry (<$29/hr)
Carpentry (>=$29/hr)
Cabinet or Fixtures
Concrete or Cement Works - sidewalks (<$24/hr)
Concrete or Cement Works - sidewalks (>=$24/hr)
Wallboard Application (<$31/hr)
Wallboard Application (>=$31/hr)
Electrical Wiring (<$30/hr)
Electrical Wiring (>=$30/hr)
Fence Construction
Hardwood Floor Laying
Glaziers (<$29)
Glaziers (>=$29)
Ceiling Installation
Landscape Gardening
Lathing
Burglar Alarm Installation, Sevrice or Repair
Masonry (<$27/hr)
Masonry (>=$27/hr)
Painting, Decorating or Paper Hanging (<$24/hr)
Painting, Decorating or Paper Hanging (>=$24/hr)
Plumbing (<$26/hr)
Plumbing (>=$26/hr)
Sheet Metal Work (<$27/hr)
Sheet Metal Work (>=$27/hr)
Tile; Stone, Mosaic or Terrazzo Work
Number of Employees (Full Time)
(Part Time)
Effective Date
Do you currently have insurance?
No
Yes
Have you had any previous claims in the last 5 years for Workers Compensation?
No
Yes
Ownership - (Additional Ownership is Optional)
Federal TAX ID Number or SSN (if Sole Prop)
Is your license currently active?
Yes
No
Do you have multiple locations?
No
Yes
Number of Locations
1
2
3
4
5
Any Work Sublet without certificates of insurance?
No
Yes
% of work sublet
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