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Main Office (413) 726-3930
info@your-bis.com

  Services home / builders electronic form

Builders Risk Electronic Form

You can submit your builder risk questionaire electronically by filling out the form below.  If you have any questions, please feel free to contact our main office at (413) 726-3930 or info@your-bis.com

Frame
Non-Combustrible
Joisted Masonry
Other
yes no
Pick a date
Value of all covered

list amount of property at all locations

One-Shot New Construction
Remodel
Reporting Form
yes no
yes no
yes no
yes no
If yes, underwriting approval required and modular question will be asked.
yes no
If yes, apartment occupancy questions will be asked.
yes no
yes no
If no, underwriter approval required.
Is the contactor insuring more than one building being constructed within 100 ft from each other at this project site?
yes no

If yes, please provide total estimated completed value of all structures under construction within 100 ft and insured with Zurich, including this one:

1-2
3-50
other
1-2
3-50
other
Loss Experienced for last three years?  Indicate cause of loss for any
claim over $5,000.
Multiple unit/multiple building questions (i.e. apartments, condos & multi-unti commercial)
Pick a date
Pick a date
Remodeling

If more than 75 years, underwriter approval required

yes no
yes no

If no, underwriter approval required

may not exceed actual cash value

If less than 50% of purchase price, underwriter approval required

Contact Us


Business Insurance Services Inc.
933 East Columbus Ave.
Springfield, MA 01105

Phone: (413) 726-3930
Fax: (413) 726-3931
Email: info@your-bis.com

 

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