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Builder Risk or Course of Construction ( COC ) Insaurancelaxmikant2020-08-28T12:21:06+00:00

BUILDERS RISK APPLICATION - COMMERCIAL

This form enables users to input data for getting Commercial Vehicle Insurance.

Step 1 of 11

9%
  • PART 1

    GENERAL INFORMATION
  • Describe any insured and uninsured losses having occurred in the past 5 years for either the Owner, Developer or General Contractor and state the date and value of each loss, before the deductible (if any) was applied?
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  • PART 2

    PROJECT INFORMATION
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  • PART 3

    CONSTRUCTION INFORMATION
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  • PART 4

    ADJACENT STRUCTURES (Attach site plan if available)
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  • PART 5

    GENERAL CONTRACTOR
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  • PART 6

    SITE PREPARATION
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  • PART 7

    SUBCONTRACTORS
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  • PART 8

    TESTING
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  • PART 9

    SITE PROTECTION INFORMATION
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  • PART 10

    FLOOD EXPOSURE
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  • PART 11

    COVERAGE INFORMATION
  • Months
  • (Replacement Cost To Rebuild: Labour, materials, professional fees etc)
  • (Finance Costs, Leasing and Marketing Expense, Legal/Accounting Expense)
    (see below for optional extensions)
    If coverage is required for either (A) or (B) below, please provide detail age, construction,condition and occupancy of such property:
  • Consumer and previous insurer reports containing personal, credit, factual or investigative information about the applicant may be sought in connection with this Applicant for Insurance or any renewal, extension or variation thereof. All provisions contained in the various forms issued under this contract shall be deemed to be contained in the present Application of Insurance. The policy may be deemed to be void and claims may be denied where:

    • 1) An applicant for a contract:
    • a) Gives false or erroneous information to the prejudice of the insurer, or
    • b) Knowingly misrepresents or fails to disclose in the Application any fact required to be stated therein; or
    • 2) The Insured contravenes a term of the Contract or commits a fraud; or
    • 3) The Insured willfully makes a false statement in respect of a claim under the contract.
  • I AM IN AGREEMENT THAT THIS DECLARATION SHALL HEREBY FORM PART OF THE INSURANCE CONTRACT.
  • MM slash DD slash YYYY
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