Commercial General Liability
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Order Additional Insured
Name of Insured/Owner
Contractors Lic# or Application Fee#
Description of work to be completed in the next twelve months
Estimated gross receipts
Estimation of total sub-contractor pay
Estimation of total "field/non-owner" payroll
Number of active owners on the job site
Number of employees on the job site
Estimation of the number of additional insured certificates required
Past or present - work involve new construction of single family residences?
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