Transcription of CONTRACTOR’S SUPPLEMENTAL APPLICATION
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CONTRACTOR’S SUPPLEMENTAL APPLICATION
MAGL 2005 05 12 Page 1 of 5 Evanston Insurance Company Markel American Insurance Company Markel Insurance Company contractor S SUPPLEMENTAL APPLICATION General contractor /Artisan contractor (To be attached to ACORD applications ) APPLICANT INFORMATION: Applicant s Name: Location Address: Mailing Address: in business: _____ Years of experience:_____ Licensed? Yes NoYear of license: _____ License #: _____ Kind of License: _____ Any previous/current license in another other state?Yes No If so, list state(s): _____ of Operations:General contractor _____% Developer _____% Subcontractor _____% With Penalty Clause _____% Construction Manager _____% (for a fee only) 3. Are there any other operations owned, operated, or managed by you?Yes No Please explain: Is coverage in place elsewhere for these operations? Yes No 4.
MAGL 2005 05 12 Page 1 of 5 Evanston Insurance Company Markel American Insurance Company Markel Insurance Company CONTRACTOR’S SUPPLEMENTAL APPLICATION General Contractor/Artisan Contractor
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