Contractors Rater

    * indicates a required field

    Contractor License #*

    Name of Business*

    Applicant Name*

    E-Mail Address*

    Phone Number*

    Address*

    City*

    Zipcode*

    Legal Structure*

    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?

    Have you had any previous claims in the last 5 years for Workers Compensation?

    Ownership - (Additional Ownership is Optional)

    Federal TAX ID Number or SSN (if Sole Prop)

    Is your license currently active?

    Do you have multiple locations?

    Any Work Sublet without certificates of insurance?

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