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Commercial Insurance Application

Help us understand your business so we can build the right coverage program. This takes about 10-15 minutes.

Need to talk to someone right now? Call (801) 505-5500
1Business Info
2Coverages
3Details
4Review
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Primary Contact
First Name is required
Last Name is required
Email is required
Best number to reach you. Used for text updates and callbacks.
Mobile Phone is required
Title / Position is required
Agent You Are Working With is required
Business Details
Legal Business Name is required
DBA / Trade Name is required
Website is required
Industry / Trade is required
Describe your industry is required
Optional - your CPA or tax preparer may have this
NAICS Code (if known) is required
If your business has one
DOT Number is required
Entity Type is required
FEIN is required
Date Business Started is required
Years in Business is required
Years of Experience (Owner) is required
The more detail you provide here, the faster we can get you accurate quotes
Description of Operations is required
List subsidiary names and their relationship is required
Describe the planned operations is required
A continuity plan can increase your bonding capacity and protect your business
Owner Information
How many owners? is required
Owner 1
Full Name is required
Email is required
Date of Birth is required
Ownership % is required
Title is required
Business Address
Mailing Address is required
Suite / Unit is required
City is required
State is required
Zip Code is required
Physical Address is required
Suite / Unit is required
City is required
State is required
Zip Code is required
Financial Overview
Projected Annual Revenue is required
Prior Year Revenue is required
Projected Annual Payroll is required
Prior Year Payroll is required
Full-Time Employees is required
Part-Time Employees is required
Desired Effective Date is required
Current Insurance
Current Insurance Company is required
Expiration Date is required
Current Annual Premium (approx.) is required
Reason for Shopping Insurance is required
Describe the cancellation or non-renewal is required
Describe your insurance requirements is required
Loss History
Describe each loss: date, description, and estimated amount is required
Select All Coverages Needed

Check every coverage type your business needs. Step 3 will show detailed questions for each selection.

Select at least one coverage type
Surety bonds require separate financial underwriting.
After you submit this commercial application, we will send you the bond application - or you can start with the Bond Scorecard. We will make sure both are handled together.
Describe the other coverage you need is required
Heads up: Most contractors in your trade also carry . Want to add any of these?
Priority
This helps us prioritize which quotes to get you first
Which coverage do you need first? is required

Complete the details below for each coverage you selected. Only your selected coverages are shown.

General Liability
Square Footage You Occupy is required
Own or Lease? is required
Liability Limits Requested is required
Contractor or General Contractor? is required
Licensing State is required
License Number is required
License Type is required
Insured Sub Cost is required
Uninsured Sub Cost is required
Type of Work Subcontracted (Insured Subs) is required
Type of Work Subcontracted (Uninsured Subs) is required
% Residential is required
% Commercial is required
% Industrial is required
Number of Additional Insureds is required
Description of Work Performed is required
Describe the lawsuit, claim, or incident is required
General Liability Additional Notes is required
Commercial Property
How many locations? is required
Location 1
Address is required
City, State, Zip is required
Occupancy is required
Alarm is required
Sprinklered is required
Building Value is required
Business Personal Property is required
Tenant Improvements is required
Square Footage is required
Year Built is required
Stories is required
Construction Type is required
Roof Type is required
Year Roof Updated is required
Year Electrical Updated is required
Year Plumbing Updated is required
Year HVAC Updated is required
Commercial Property Additional Notes is required
Commercial Auto
Desired Liability Coverage is required
Uninsured Motorist is required
Comp/Collision Deductible is required
Hired/Non-Owned Liability is required
All vehicles titled to business? is required
Drivers
How many drivers? is required
For more than 10, please upload a file
Driver 1
Full Name is required
Date of Birth is required
License Number is required
State Licensed is required
CDL? is required
Accidents/Violations (5yr)? is required
Vehicles
How many vehicles? is required
For more than 10, please upload a file
Vehicle 1
Year is required
Make is required
Model is required
VIN is required
Value is required
Garaging Zip is required
Vehicle Type is required
Radius of Use is required
GVW is required
Commercial Auto Additional Notes is required
Workers Compensation
Enter 1.00 if unknown or first-year policy
Experience Modification Rate (EMR) is required
All states where employees work
State(s) Where WC Coverage Needed is required
Current WC Carrier is required
Current WC Premium (approx.) is required
Current WC Policy Expiration is required
Owners / Officers
How many owners/officers? is required
Owner/Officer 1
Name is required
Title is required
Include or Exclude? is required
Ownership % is required
Duties is required
Employee / Payroll Categories
How many payroll categories? is required
For more than 8, please upload a file
Category 1
Employee Category / Job Description is required
Number of Employees is required
Annual Payroll is required
Workers Comp Additional Notes is required
Inland Marine / Equipment
How many items? is required
For more than 10, please upload a file
Item 1
Item Description is required
Make / Model is required
Serial Number is required
Item Value is required
Year is required
Owned or Leased? is required
Combined value of hand tools, drills, cameras, small equipment not listed above
Total Value of Misc. Tools/Equipment (under $500 each) is required
Rented Equipment Coverage
For specialty equipment you rent from others on a job-by-job basis (not the equipment scheduled above).
This field is required
Total spent renting equipment last 12 months
This field is required
Most expensive single piece you'd ever rent - sets the per-item limit
This field is required
This field is required
Inland Marine Additional Notes is required
Builders Risk
Project Type is required
Are you the Owner or Contractor? is required
Project Location Address is required
Building Use is required
Total Project Value is required
Construction Start Date is required
Expected Completion Date is required
Construction Type is required
Number of Stories is required
Builders Risk Additional Notes is required
Errors & Omissions (E&O)
Desired Limits is required
Annual Receipts from Professional Services is required
Type of Professional Services Provided is required
Number of Licensed Professionals is required
E&O Additional Notes is required
Cyber Liability
Desired Limits is required
Approx. Number of PII Records Stored is required
Most carriers require this for approval
Most carriers require this for approval
Cyber Additional Notes is required
Employment Practices Liability (EPLI)
Desired Limits is required
EPLI Additional Notes is required
Pollution Liability
Desired Limits is required
Type of Pollutants Handled is required
Pollution Liability Additional Notes is required
Directors & Officers (D&O)
Desired Limits is required
D&O Additional Notes is required
Crime
Desired Limits is required
Employees Who Handle Money / Finances is required
Crime Additional Notes is required
Umbrella / Excess Liability
Desired Excess Liability Limit is required
Umbrella Additional Notes is required
Cargo
Desired Limits is required
Describe the Cargo Carried is required
Upload Documents

Upload your current policy declarations pages and any other supporting documents.

Drag files here or click to browse
PDF, DOC, XLS, JPG, PNG - max 25MB each

    Additional Information
    Anything else we should know? is required
    Review Summary
    Authorization
    You must agree to continue

    Completion of this application does not constitute the purchase of insurance. No coverage may be added, changed, or bound as a result of submitting this form. All coverage must be confirmed by the agency in writing subject to an acceptable signed application meeting the underwriting guidelines of the insurance company.

    gritinsurance.com  |  (801) 505-5500
    Salt Lake City, UT  |  Park City, UT  |  Challis, ID