Contractor Contractor Contractor Contractor Contractor Employee Employee Employee Employee Employee Upkeep of sidewalks/driveways: Contractor Contractor Contractor Contractor Contractor Employee Employee Employee Employee Employee Snow/ice removal operations: Contractor Contractor Contractor Contractor Contractor Pool: (See Section 10.) Yes No Yes No Yes No Yes No Yes No If occupancy is other than habitational, please describe the occupancy and square footage: Percent of university or college students % % % % % as tenants: Vacant? Yes No Yes No Yes No Yes No Yes No If yes, percent of vacancy: % % % % % Building(s) condemned or scheduled for Yes No Yes No Yes No Yes No Yes No demolition: Conversion being done to or from Yes No Yes No Yes No Yes No Yes No condominiums and/or townhouses: 4. Subcontracted Work Exposures: Any new ground up constructions anticipated within the next twelve (12) Yes No Yes No Yes No Yes No Yes No months? If yes, cost of construction: $ $ $ $ $ Renovation anticipated within the next Yes No Yes No Yes No Yes No Yes No twelve (12) months? If yes, cost of renovation: $ $ $ $ $ Renovation going on currently? Yes No Yes No Yes No Yes No Yes No If yes, type of renovation: Cost of renovation: $ $ $ $ $ General contractor used? Yes No Yes No Yes No Yes No Yes No Subcontractors used? Yes No Yes No Yes No Yes No Yes No If yes, certificate of insurance on file? Yes No Yes No Yes No Yes No Yes No Limits required: $ $ $ $ $ The applicant named as additional Yes No Yes No Yes No Yes No Yes No Insured on their policy? Hold harmless agreement in favor of the Yes No Yes No Yes No Yes No Yes No applicant in place? 5. Updates: Provide Year and Indicate Full or Partial Loc. No. 1 Loc. No. 2 Loc. No. 3 Loc. No. 4 Loc. No. 5 Update Per Location
Contractor Contractor Contractor Contractor Contractor Upkeep of sidewalks/driveways: Employee Contractor Employee Contractor Employee Contractor Employee Contractor Employee Contractor Snow/ice removal operations: Employee Contractor Employee Contractor Employee Contractor Employee Contractor Employee Contractor Pool: (See Section 10.) Yes No Yes No Yes No Yes No Yes No If occupancy is other than habitational, please describe the occupancy and square footage: Percent of university or college students as tenants: % % % % % Vacant? If yes, percent of vacancy: Yes No % Yes No % Yes No % Yes No % Yes No % Building(s) condemned or scheduled for demolition: Yes No Yes No Yes No Yes No Yes No Conversion being done to or from condominiums and/or townhouses: Yes No Yes No Yes No Yes No Yes No 4. Subcontracted Work Exposures: Any new ground up constructions anticipated within the next twelve (12) months? Yes No Yes No Yes No Yes No Yes No If yes, cost of construction: $ $ $ $ $ Renovation anticipated within the next twelve (12) months? Yes No Yes No Yes No Yes No Yes No If yes, cost of renovation: $ $ $ $ $ Renovation going on currently? Yes No Yes No Yes No Yes No Yes No If yes, type of renovation: Cost of renovation: $ $ $ $ $ General contractor used? Yes No Yes No Yes No Yes No Yes No Subcontractors used? Yes No Yes No Yes No Yes No Yes No If yes, certificate of insurance on file? Yes No Yes No Yes No Yes No Yes No Limits required: $ $ $ $ $ The applicant named as additional Insured on their policy? Yes No Yes No Yes No Yes No Yes No Hold harmless agreement in favor of the applicant in place? Yes No Yes No Yes No Yes No Yes No 5. Updates: Provide Year and Indicate Full or Partial Update Per Location Loc. No. 1 Loc. No. 2 Loc. No. 3 Loc. No. 4 Loc. No. 5