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» BCIN Professional Liability Insurance Application
BCIN Design Professional Liability Insurance Application
Here's the additional information we need to quote your BCIN Professional Liability Insurance!
Please confirm the full legal name of your company to be shown on the Certificate of Insurance
*
If you are operating as a sole proprietorship (i.e. without Inc., Ltd., LLC etc...), please include "operated by" or o/b followed by your first and last name after the company name.
Kindly Just Confirm The Best Email To Reach You at
*
We just need it to match up for your completed application with the file we've already started for you!
Is this a New Business?
Yes, just starting up
No, I already have BCIN insurance, but I'm looking for better options
What is the RETROACTIVE DATE on your current policy or what M/D/Y did you first start your BCIN professional liability policy?
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Please select any/all that apply
I perform Construction, Installation, Erection, Manufacturing, Fabrication, Assembly, AND/OR I provide other professional services (ex. construction or project management) in addition to BCIN design services.
I am aware of a prior claims or know of circumstances that may give rise to a claim for the insurance I'm applying for.
A portion of the BCIN design work I do is subcontracted to a third party.
What is the date of loss of the claim/incident?
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Please provide a brief description of the claim/incident, the amount paid, reserved and/or if it is open or closed.
The more details the better!
Have you had more than one claim?
No, only the one
Yes
What % of your work is Subcontracted to others?
What Services do you provide?
*
Interior Design / Space Planning
Design/Drafting
Project Management
Project Co-ordination
Other (please specify)
Select all that apply
Please describe what Other Services you provide
What type of projects do you work on?
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Private Housing
Commercial Buildings
Buildings 3 stories or under
Buildings 4 stories or over
Other (please specify)
Select all that apply
Please describe what Other Project types you work on
What was your Total Gross Revenue/Sales for last 12 months from BCIN services provided to others?
What is your projected Total Gross Revenue/Sales for the next 12 months?
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How Much Insurance Would You Like?
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Select the limit you would like a quote for or that you are required to carry
$ 250,000 Each Claim / $ 500,000 Annual Aggregate
$ 500,000 Each Claim / $1,000,000 Annual Aggregate
$1,000,000 Each Claim / $2,000,000 Annual Aggregate
$ 2,000,000 Each Claim / $2,000,000 Annual Aggregate
Is there anything else you'd like to share with us or think we should know about you, your operations, the risk etc.?
Claims Experience
*
I confirm that there are no incidents that may result in a claim under any of the insurance for which I am applying to purchase on this site, there is no legal actions taken against any of the companies to be insured within the last five years, there are no cease and desist orders issued against my company, and no instances of a partner or director being found guilty of any criminal, dishonest, or fraudulent activity, nor any investigations by a regulatory body.
Consent
*
I accept and confirm that I have verified the information supplied and that it accurately reflects the details of the company applying for insurance. Additionally, I authorize the use of this information to attempt to secure insurance quotes on my behalf and agree that I can contact by ALIGNED Insurance Ltd. regarding insurance matters.
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About Us
Our Team
Why Work With Us?
Business Insurance Products
Commercial General Liability
Professional Liability Insurance
Commercial Property Insurance
Commercial Auto Insurance
Small Business Insurance
Cyber Insurance
Directors & Officers Liability Insurance
Ocean Marine Insurance
Equipment Breakdown Insurance
Pollution Liability Insurance
Surety & Bonding Insurance
Cannabis Insurance
Other Insurance Products
Online Insurance Products
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