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Pest Control Business Insurance


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Company Information
Company Name
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Street
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City
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State
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ZIP / Postal Code
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Primary Phone Number
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Alternate Phone Number
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E-Mail Address
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Business Type
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Company Owner
First Name
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Last Name
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Gross Annual Sales
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Square Footage of Location
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How long in business?
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How many years experience in this field?
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Trade Organization Membership
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Prior Insurance
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Length of Coverage (Months and Years)
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Expiration Date
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Number of Additional Insureds Needed
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Describe any claims, lawsuits, administrative actions
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Number of Owners
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“Employees” include: Sole proprietor, Partner, Executive Officers, Seasonal employees, Part-time employees, Full-time employees.
Number of Full Time Employees
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Number of Part Time Employees
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Annual Employee Payroll
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Please explain pre-employment screening requirements
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Subcontractors Used
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Annual Cost of Subcontractors
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What state(s) do you offer products or services?
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What percentage of your services are provided at:
Commercial, Industrial or Institutional Locations
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Food Service, Restaurant, Kitchen Locations
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Residential Homes and Apartments
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How many WDI inspections are conducted each year?
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Describe any aerial, drone, crop spraying, tenting services offered
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Describe treatment of private ponds, lakes, streams, or other bodies of water?
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Describe bedbug treatments, heat treatments
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List main chemicals used for treatment
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Attach your customer service agreement
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Do you need pricing on commercial auto, buildings, business property?
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Do you need pricing on a surety bond?
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How did you hear about us?
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Full Name of Person Entering Application
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Important Notice
Any submissions or payments made via this website do not constitute a binding agreement to your policy or coverages. Changes and payments to policies are not effective or binding until you, or any party involved, receive official notice from either your insurance agent, or your insurance company. If you have any questions, please feel free to contact us.

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