Course of Construction Insurance

Builders risk insurance is designed to insure construction projects and it covers buildings and other structures while being built, including building materials and equipment intended to become part of the building or structure. Coverage applies to property while at the job site, offsite in storage, and in transit.(Coverage for construction equipment, i.e., forklifts, bulldozers, mobile tools, and soon, would be provided by contractors equipment insurance.)



First & Last Name:

Business License #:

Telephone:

Email Address:

How did you hear about Pike Insurance?

What size T-Shirt do you wear?

What size Hat do you wear?



Company Name:

Years in Business:

Mailing Address:

City:

State:

Zip Code:

Company Telephone:

Company Fax:



Job Site Physical Address:

City:

State:

Project Type:

Contract Price ($):

Project Start Date (mm/dd/yy):

Project Completion Date (mm/dd/yy):

What type of Structure?

Type of Construction?

Number of floors in building?

Number of Structures?

Total Building(s) SqFt:

Completed Value of Building(s) $ ?

How many feet from a Fire Hydrant?

Job Site Security:	yes no

Is the project within 1,000 ft of Tidal Waters?	yes no



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