Britton and Britton Insurance
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Builders Risk Insurance Quote Form
Simply fill in the following information and a Britton & Britton agent will contact you personally with more information.
Step
1
of
4
25%
Name
*
First
Last
Business Name
(If Applicable)
Mailing Address
*
Street Address
City
ZIP Code
Property or Location Address
*
(Where The Project/Work is Being Completed)
Same as previous
Street Address
City
ZIP Code
Phone
*
Phone 2
Email
*
Website
Purchase Date
*
MM slash DD slash YYYY
Projected Start Date
*
MM slash DD slash YYYY
Expected Completion Date
*
MM slash DD slash YYYY
Which Option Best Applies to Your Project
*
New Construction
Remodel
Renovation?
Type of Property
*
Residential
Commercial
Vacant Home
Land
Commercial Building
Other
Please Explain
Intended Occupancy Once Complete
*
Private Home
Tri-Plex
Commercial
Shopping Mall
Restaurant
Other
Please Explain
Will the Structure be Occupied During Construction?
*
If "Yes", Please Provide Details
Yes
No
Please Provide Details
What is The Value of The Existing Structure
*
(not including land)
What is The Cost of Work to be Performed on The Project
*
Total Completed Value of Property/Project
*
Provide a Description of The Project
*
Total Square Footage of The Completed Project Once Finished?
*
Is There an Existing Structure on The Property?
*
Yes
No
Provide a Description of The Existing Structure
*
Please Describe Any Work on Existing Structure
*
Year Existing Structure Built
*
MM slash DD slash YYYY
Number of Stories on the Existing Structure
*
Current Square Footage
*
Include or Exclude Coverage for the Existing Structure?
*
Include
Exclude
If Yes, How Much?
*
Will the Existing Structure be Insured by Another Policy During Construction?
*
Yes
No
Does the Building Have an Operable Sprinkler System?
*
Yes
No
Is the Existing Structure Listed on any Historical Registry or Subject to a Historical Society Regulation?
*
Yes
No
Has the Existing Structure Been Moved or Will it be Moved as Part of This Project
*
Yes
No
Construction Material
*
(Pick One)
Frame - exterior walls constructed of wood or other combustible materials such as brick veneer, stone veneer, wood and stucco on wood.
Joisted Masonry - exterior walls constructed of masonry materials such as brick, concrete, block, stone or similar materials and the floors and roof are of wood construction.
Non-Combustible - exterior walls, floors and roof constructed of metal, gypsum or other non-combustible materials.
Masonry Non-Combustible - exterior walls, floors and roof constructed of masonry or fire resistive materials with fire resistance rating of not less than 1 hour.
Fire Resistive - exterior walls, floors and roof constructed of masonry or fire resistive materials with a fire resistance rating of not less than 2 hours.
Other
Multiple Locations to be Covered?
*
Yes
No
Is the Builders Name Different Than the Name Insured?
*
Yes
No
What is the Builders Name?
*
Does Builder/Remodeler/Owner/General Contractor Have at Least 2 Years’ Experience
*
If "No", the Risk is Not Eligible
Yes
No
Number of Structures Remodeled / Built During the Past 12 Months
*
Number of Structures Projected for the Next 12 Months
*
Has the Builder/Remodeler Had any Single Loss / Claim Over $10,000 in the Last 3 Years?
*
Yes
No
Any Previous Losses at This Location as a Result of Quake, Flood, Wind, Fire or Vandalism?
*
Yes
No
Name
This field is for validation purposes and should be left unchanged.
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