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Associated Insurance Professionals, Inc.
Action Insurance Professionals - AIP Action Insurance Agency
A New Mexico Corporation

New Mexico - Colorado - California - Arizona - Nevada
Licensed Agents and Brokers

 

Paying to much for your roofing insurance? From the small 1 man operation to the big roofing company, associated insurance can help you with your insurance needs. With many great companies that can offer coverage, we can give you low rates year after year. Writing business in Arizona, California, Colorado, and New Mexico - call John Dziak or submit your information below to get a no obligation insurance quote.

Roofers Insurance Quote

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WE NEED THIS INFORMATION !

One of the key factors in obtaining an accurate insurance quote is accurate information. We must have all of this information to get you the best possible insurance quote for what you need and want. Please help us do a good job for you. Get us the right information.

If you have a question about any of the information you need to provide us , please call us during regular business and speak with one of representatives.

 

Your Name*
 

 Business Name*
 		 Business Address*
 
City*
 		 State
 Zip Code*
 
Phone Number*
 		 E-mail
Business Description*
(as much detail as possible, please)
 

Applicant is an*
 
 
What percent of your work is residential (homes, condominiums)?
What percent of your work is commercial (office buildings, schools, retail establishments)?
What percent of your work is industrial (plants, warehouses)?


Type of Roofing Operating


Residential


Commercial


Industrial

% of Total
Operations

 What percentage of work is New Construction?

 

 

 What percentage of work is Repair/Patching?

 

 

 What percentage of work is Replacement?

 

  

 

 

100%

100%

100%

100%

 What percentage of work is on Pitched Roofs?

 What percentage of work is on Flat Roofs?

 

100%

100%

100%

100%

Indicate type of work performed and percentage
of operation within Type of Roofing Operation.


Residential


Commercial


Industrial

% of Total
Operations

 Shingles/Shakes:

   Asphalt

 

   Fiberglass

 

   Wood

 

   Concrete

 

   Slate

 Metal

 Shingle Ply

 Tile

 Polyurethane Foam:

   Sheet Form

 

   Sprayed

 Hot Tar and/or Asphalt/Built up

 Rubber/Elastomerics

Other (describe):

 

100%

100%

100%

100%
 

Check work done other than roofing
Waterproofing Siding Asbestos removal Rain gutters Carpentry  Insulation 
Other (describe)

If hot tar, torch or other “hot process” is used, explain in detail the process and what safety precautions are used
 

Subcontractor Information

Do you subcontract any work?

If yes, what percentage do you subcontract?
%

Check the type of work subcontracted out:
Waterproofing Siding Hot tar Rain gutters  Carpentry  Insulation 
Other (describe)

What is the annual cost of the work subcontracted out?

Are Certificates of Insurance (of equal limits) received on all subcontracted work?

How long are Certificates of Insurance kept?
Until job ends One year Two years Three years   More than three years  Never kept

Do you utilize day laborers”?

If yes, how many within a year?
 
General Information
List any roofing/builder associations in which you are a member

Receipts for previous three years:

 Last Year:
Year Before Last:

3 Years Ago:
Do you offer warranties?
What is the average height of buildings you work on?
What is the tallest building you will work on?
Where do you dispose of trash/waste/scraps?
Is this disposal process environmentally safe?
Have you ever used, sold, installed or worked with asbestos?
Any LPG storage?
Years of experience?
 
Materials & Equiptment
List the type of owned equipment used on the job.

List any equipment rented and check the frequency of such rental
(Type of Equipment, How often do you rent this equipment?, Daily Weekly Monthly Yearly)
 

Public Protection
Do you have a written safety program?

How do you protect the general public from potential injury?

Check one or more:
Rope off work area Signs Cones Flashing lights Man always on the grounds No protection necessary  Other (describe)

How are materials lifted to the roof?
Ladder  Hoist  Pulley  Crane 
Other (describe)
Are materials and equipment left overnight at job site?

In what manner are openings in roof protected overnight?
Tarp Waterproof plywood Never leave openings
Other (describe)

What on-the-job precautions do you take when rained on?
Leave job immediately Seal openings
Keep on working  Never start job
Are all jobs inspected by a foreman or the contractor at completion before leaving the job site?
 

Special Requests/Remarks

 

 


 You can call our customer service representatives Monday through Friday
9 am - 5:30 pm and Saturday 9 am - 2 p.m. to give you personalized phone quotes.

 

  
 
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Associated Insurance Professionals, Inc.
1429 Carlisle Blvd NE
Albuquerque , NM , 87110
505-265-3704
CA License #0F64143