HVAC Insurance Direct - Contractor Quote

Pollution Liability Included.

HVAC contractor insurance that includes pollution and refrigerant coverage — without surprise exclusions.

✓ Pollution & refrigerant liability covered

✓ GL + Workers Comp bundled

✓ Tools & equipment protection

✓ We shop multiple carriers so you don't have to!

One quick form. Multiple carrier quotes. Your best rate.

🔧 HVAC Insurance Direct

Business Information

Applicant Name Business / Entity Name Business Address

City

State

Zip Code

Business Phone

Contact Email

Years in Business

Years of Experience in Plumbing

Business Structure

Are you licensed?

Contractor's License Number

Financial Overview

Projected Gross Revenue

Upcoming policy term

# Active Owners

Employee Payroll

Excluding owners

Estimated Annual Subcontracting Cost

HVAC Operations & Specifics

Breakdown of Work Type (Must equal 100%)

% Residential

% Commercial

% Industrial

Total percentage must equal 100%. Current: 0%

% General Contractor

% Subcontractor

Any boiler work? (install/service/repair)

Any high-pressure steam pipe work?

Do you perform any crane operations? Do you install or work on Air Conditioning Units? Do you install or work on any Refrigeration Equipment? Do you have any welding operations?

Do you have preventative fire measures in place at all times including: clearing the area of all flammable exposures, shielding non-movable items with fire-resistant materials, and maintaining a 30-minute cool-down fire watch?

Subcontractor Management

Do you hire subcontractors?

Require COIs before starting?

Do you utilize written contracts with all subs including indemnification/hold harmless in your favor?

Use 1099 laborers?

Carry Workers Comp?

What specific jobs are they hired for?

Risk & Cross-Trade Questions

Any known loss/claim involving mold or construction defect?

Please describe:

Perform fire/water restoration?

Handle hazardous materials?

Perform Roofing?

Perform HVAC work?

Maximum building height (feet): What States do you perform work in?

Quote Options

Current GL Carrier (if any) Any GL claims in the last 3 years?

Please describe claims:

Would you like a Workers Comp Quote?

# Full-Time Employees

# Part-Time Employees

Estimated WC Payroll

Preferred Payment Plan

Monthly Annual

Additional Insured & Certificates

Do you have any Additional Insureds?

Loss Payee Lienholder Mortgagee Additional Insured

Name: Address:

City:

State:

Zip:

Do you have additional Names?

Loss Payee Lienholder Mortgagee Additional Insured

Name: Address:

City:

State:

Zip: