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Welcome to Mullen Insurance Agency Inc.

 

Complete and submit this supplement along with the General Liability Quick Quote Request.

Agency Information            

    I am:    If you are an agent, Agency Name     Phone

            required!            Email Address:    (retail customer or agent)

Applicant Information            
Name:

DBA:
Description of your business:

General Questions
 Does the INSURED do any work that involves: Roofing?   Plumbing?  Tract Housing? Do not include work done by subcontractors.
Does the INSURED perform any work during the construction of: Apartments? New Residential Construction?  Multi Family Dwellings?
Is work done on buildings exceeding 3 stories in height?  
Is work done on concrete foundation repair or highway work?  

Work Performed   
Only include the work that is done by the insured.  Do not include work done by subcontractors.
   Work Performed    % Of Total Operations
Exterior Carpentry (framing) (no roofing, no buildings exceeding 3 stories)
Interior Carpentry (includes doors, windows, cabinets, interior trim)
Exterior Painting (no buildings exceeding 3 stories in height)
Interior Painting
Dry Wall Work (sheet rock)
Siding (wood)
Siding (other)
Concrete Construction (no foundation repair or highway work)
Carpet Installation
Tile/Stone Installation (interior work)
Masonry Work (exterior tile or brick work)
Metal Bldg Erection What percent is welding?
Electrical Work within buildings
Wall Papering (paperhanging)
Stucco Work (No "EIFS")
Other
   TOTAL OF ALL WORK =  100%

Additional Information