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General Liability and Work Comp Questionnaire
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Home
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New corporation
Existing corporation
General Liability and Work Comp Questionnaire
Contact
Careers
EN
ES
Menu
EN
ES
Home
Services
Blog
Form
New corporation
Existing corporation
General Liability and Work Comp Questionnaire
Contact
Careers
EN
ES
Menu
Home
Services
Blog
Form
New corporation
Existing corporation
General Liability and Work Comp Questionnaire
Contact
Careers
EN
ES
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Date
*
Contact name:
*
First
Last
Personal phone:
*
Personal address:
Address Line 1
Address Line 2
City
State / Province / Region
Postal Code
How did you hear about our business?
*
Personal referral from
Social Networks
Other way
Personal referral
Where did u born?
Company Name:
Company Email:
*
Company Adress:
Address Line 1
Address Line 2
City
State / Province / Region
Postal Code
Web Page:
How long in existence?
What licenses does the business have?
State
Country
Other
How many employees (W-2) ?
Do you have an accountant?
*
Yes
No
Do you have someone who does your payroll?
*
Yes
No
Copy of the last report
Click or drag a file to this area to upload.
¿Subcontractors?
*
Yes
No
¿How many?
What insurance company or agency do you have for the following
General Liability Insurance:
Workers Compensation Insurance:
Car's Insurance:
Health Insurance:
Home/Mortgage/Rent Insurance:
Do you have a client or job waiting for a Certificate of Insurance?:
Do you have a financial advisor?
*
Yes
No
Do you have a retirement plan?
*
Yes
No
Explain:
Did you do PERSONAL taxes
*
2020
2021
2022
None
Brng COPY of last year
Click or drag a file to this area to upload.
What is your immigration status?
American citizen
Permanent resident
Tourist visa
Work permit
Bring ORIGINAL of your documents
Click or drag a file to this area to upload.
¿What is your marital status?
*
Single
Married
Divorced
o you have any urgent business matters to resolve?
*
Yes
No
Explain:
Bring copies of letters received
Click or drag a file to this area to upload.
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