Builder's Risk Property Insurance
Inquiry Form
Business Name
(if any)
         Form of Business: 
Contact Name
Address:
City:
   State:    Zipcode: 
Phone:
     Fax: 
Email Address:
Are you a member of the Steel Frame Alliance? Yes  /  No 

Property Location:  Policy Type:

Address:
City:
    State:    Zipcode: 
County
Type of Construction:
               Total Square Footage: 
Construction Material:
Project Start Date:    Completion Date: 
Value property at all locations:$         DEDUCTIBLE: 
General Questions
Is existing structure coverage desired? If yes, existing structure value: $  Yes No
Is the builder's name different than the named insured?
If yes, enter builder's name: 		 Yes No
Do you have any additional insureds? Yes No
Modular Home Construction.....
Is the structure modular? Yes No
Who provides transit coverage......................? 
How are homes transported to the job site.....? 
Estimated time to complete each structure..... 
Does the manufacturer put the four sides together and then the builder finish it off? Yes No
Does the manufacturer have a web site address? (Web Site: ) Yes No
Apartments, Condominiums or Multi-Unit Structures....
Is the location apartments, condominiums or multi-unit structure(s)?
Number of buildings
Number of units per building
Value per building
Distance between buildings
Total project completed value
Start and completion date of each building to 
Will the structure be occupied during construction?
If yes, describe: 		 Yes /  No
Yes No
Any coverage for development / subdivision fences, walls or signs? If yes, value:$  Yes No
Does builder/remodeler have at least 2 years experience?
  Type of Builder: 		 Yes No
Any foundation, structural changes or movement of load bearing walls? Yes No
Is the contractor insuring more than one building being constructed within 100 feet from each other at this project site?
If yes, please provide total estimated completed value of all structures under construction within 100 feet and insured with Zurich, including this one: $ 		 Yes No
Number of structures built/remodeled during the past 12 months?1 - 2 |  3 - 50 |  Other ()
Number of structures projected for the next 12 months? 1 - 2 |  3 - 50 |  Other ()

Loss experience for last 3 years? Indicate cause of loss for any claim over $5,000
DATE of LOSS CAUSE & WHAT HAPPENED......

Mortgagee on Property
Mortgagee Name
Address:
City:
   State:    Zipcode: 
Phone:
        Fax: 

M c G R A T H   I N S U R A N C E   G R O U P

4170 William Penn Highway, Murrysville, PA. 15668-1890
(724) 327-8474 (FAX) 327-7911
Toll Free: 1-800-977-2999