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| Preferred Method of Contact: |
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| Do you currently have business insurance?: |
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| Has insurance ever been denied or cancelled for this business: |
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| Feel free to white out premiums. |
| Do you require property insurance: |
Do you have any business property to insure? |
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Your Equipment (including leased equipment), tools, and Leasehold/Unit Improvements are insured for the Replacement Cost New. |
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if applicable |
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| Do you have any US subsidiaries: |
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*All information is kept strictly confidential |
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| Do you always carry out work under a written contract signed by every client: |
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| Do you employ subcontractors?: |
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| Do you sign reciprocal hold harmless agreements with sub-contractors: |
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| Do you confirm that contractors have their own Errors and Omissions and General Liability insurance: |
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| Do you comply with any internationally recognized standards for information governance: |
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| Please check all that apply that relate to companies or services where you store sensitive data or who you rely upon to provide critical business services: |
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| Please check all that apply that relate to controls that you currently have implemented within your IT infrastructure (including where provided by a third party). : |
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| Have you ever sent or received a cease and desist letter relating to intellectual property rights: |
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| Have you ever sent or received a notification of an actual or potential claim letter relating to intellectual property rights: |
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This is a good place to add relevant details on the owners previous experience or other important details about the business. If there have been claims please advise the estimated date(s) and estimate amount(s) paid for each |
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| Required to prove you're not a bot! |
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