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Company Information
Company Name
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Contact Name
*
Contact Title
*
Email
*
Phone
*
City
*
State
*
Zip
*
Description of Operations
*
Class Codes
You must select at least one class code for your business and provide a total of gross receipts for that class code. You may optionally select up to three additional class codes.
First Class Code
*
Select One
91111 - Air Conditioning Systems
91580-C - General Contractor – Commercial
91580-R - General Contractor – Residential
91340 - Carpentry Framing
91341 - Carpentry Interior
91342 - Carpentry NOC
91343 - Carpentry Wood – Shop Work Only
91523 - Cleaning – Outside Building
91551 - Commercial Communication Equipment Installation
91560 - Concrete Foundation
91629 - Debris Removal
91746 - Window and Door Installation
92101 - Drilling NOC
92215 - Driveway Parking/Sidewalk Paving
92338 - Drywall
92451 - Electrical Equipment – Exterior
92478 - Electrical – Interior
11207 - Equipment Rental – With Operator
94007 - Excavation
94276 - Fencing
94569 - Flooring
95124 - Furniture Installation
95410 - Grading
95505 - Guniting
95555 - GC – Remodel
95647 - HVAC
96053 - Home Furnishing Installation
96409 - Insulation
96410 - Insulation – Mechanical Installation
96611 - Interior Decorators
97047 - Landscape
97447 - Masonry
97650 - Metal Erection – Decorative
97655 - Metal Erection – Structural
98304 - Painting – Exterior
98305 - Painting – Interior
98344 - Paper Hanger
98449 - Plastering & Stucco
98482 - Plumbing – Commercial
98483 - Plumbing – Residential
98636 - Refrigeration Systems and Equipment
98677 - Roofing – Commercial
98679 - Roofing – Residential
98705 - Sand Blasting
98777 - Commercial Tenant Improvement
98806 - Septic Tank – Installation/Service/Repair
98820 - Sewer Mains
98884 - Sheet Metal
98967 - Siding an Decking
98993 - Sign Erection – Repair/Installation
99321 - Street/Road Paving and Repair
99505 - Swimming Pool Cleaning
99507 - Swimming Pool Installation
99650 - TV Radio Receiving Set Installation/Service/Repair
99746 - Tile and Marble Installation
99777 - Tree Trimming
99946 - Water Mains Connections
99969 - Welding
99975 - Window Cleaning
99999-C - Remodel – Commercial
99999-R - Remodel – Residential
Other - Please Provide Details in Notes
First Class Code Gross Receipts
*
Second Class Code
Select One
91111 - Air Conditioning Systems
91580-C - General Contractor – Commercial
91580-R - General Contractor – Residential
91340 - Carpentry Framing
91341 - Carpentry Interior
91342 - Carpentry NOC
91343 - Carpentry Wood – Shop Work Only
91523 - Cleaning – Outside Building
91551 - Commercial Communication Equipment Installation
91560 - Concrete Foundation
91629 - Debris Removal
91746 - Window and Door Installation
92101 - Drilling NOC
92215 - Driveway Parking/Sidewalk Paving
92338 - Drywall
92451 - Electrical Equipment – Exterior
92478 - Electrical – Interior
11207 - Equipment Rental – With Operator
94007 - Excavation
94276 - Fencing
94569 - Flooring
95124 - Furniture Installation
95410 - Grading
95505 - Guniting
95555 - GC – Remodel
95647 - HVAC
96053 - Home Furnishing Installation
96409 - Insulation
96410 - Insulation – Mechanical Installation
96611 - Interior Decorators
97047 - Landscape
97447 - Masonry
97650 - Metal Erection – Decorative
97655 - Metal Erection – Structural
98304 - Painting – Exterior
98305 - Painting – Interior
98344 - Paper Hanger
98449 - Plastering & Stucco
98482 - Plumbing – Commercial
98483 - Plumbing – Residential
98636 - Refrigeration Systems and Equipment
98677 - Roofing – Commercial
98679 - Roofing – Residential
98705 - Sand Blasting
98777 - Commercial Tenant Improvement
98806 - Septic Tank – Installation/Service/Repair
98820 - Sewer Mains
98884 - Sheet Metal
98967 - Siding an Decking
98993 - Sign Erection – Repair/Installation
99321 - Street/Road Paving and Repair
99505 - Swimming Pool Cleaning
99507 - Swimming Pool Installation
99650 - TV Radio Receiving Set Installation/Service/Repair
99746 - Tile and Marble Installation
99777 - Tree Trimming
99946 - Water Mains Connections
99969 - Welding
99975 - Window Cleaning
99999-C - Remodel – Commercial
99999-R - Remodel – Residential
Other - Please Provide Details in Notes
Second Class Code Gross Receipts
Third Class Code
Select One
91111 - Air Conditioning Systems
91580-C - General Contractor – Commercial
91580-R - General Contractor – Residential
91340 - Carpentry Framing
91341 - Carpentry Interior
91342 - Carpentry NOC
91343 - Carpentry Wood – Shop Work Only
91523 - Cleaning – Outside Building
91551 - Commercial Communication Equipment Installation
91560 - Concrete Foundation
91629 - Debris Removal
91746 - Window and Door Installation
92101 - Drilling NOC
92215 - Driveway Parking/Sidewalk Paving
92338 - Drywall
92451 - Electrical Equipment – Exterior
92478 - Electrical – Interior
11207 - Equipment Rental – With Operator
94007 - Excavation
94276 - Fencing
94569 - Flooring
95124 - Furniture Installation
95410 - Grading
95505 - Guniting
95555 - GC – Remodel
95647 - HVAC
96053 - Home Furnishing Installation
96409 - Insulation
96410 - Insulation – Mechanical Installation
96611 - Interior Decorators
97047 - Landscape
97447 - Masonry
97650 - Metal Erection – Decorative
97655 - Metal Erection – Structural
98304 - Painting – Exterior
98305 - Painting – Interior
98344 - Paper Hanger
98449 - Plastering & Stucco
98482 - Plumbing – Commercial
98483 - Plumbing – Residential
98636 - Refrigeration Systems and Equipment
98677 - Roofing – Commercial
98679 - Roofing – Residential
98705 - Sand Blasting
98777 - Commercial Tenant Improvement
98806 - Septic Tank – Installation/Service/Repair
98820 - Sewer Mains
98884 - Sheet Metal
98967 - Siding an Decking
98993 - Sign Erection – Repair/Installation
99321 - Street/Road Paving and Repair
99505 - Swimming Pool Cleaning
99507 - Swimming Pool Installation
99650 - TV Radio Receiving Set Installation/Service/Repair
99746 - Tile and Marble Installation
99777 - Tree Trimming
99946 - Water Mains Connections
99969 - Welding
99975 - Window Cleaning
99999-C - Remodel – Commercial
99999-R - Remodel – Residential
Other - Please Provide Details in Notes
Third Class Code Gross Receipts
Fourth Class Code
Select One
91111 - Air Conditioning Systems
91580-C - General Contractor – Commercial
91580-R - General Contractor – Residential
91340 - Carpentry Framing
91341 - Carpentry Interior
91342 - Carpentry NOC
91343 - Carpentry Wood – Shop Work Only
91523 - Cleaning – Outside Building
91551 - Commercial Communication Equipment Installation
91560 - Concrete Foundation
91629 - Debris Removal
91746 - Window and Door Installation
92101 - Drilling NOC
92215 - Driveway Parking/Sidewalk Paving
92338 - Drywall
92451 - Electrical Equipment – Exterior
92478 - Electrical – Interior
11207 - Equipment Rental – With Operator
94007 - Excavation
94276 - Fencing
94569 - Flooring
95124 - Furniture Installation
95410 - Grading
95505 - Guniting
95555 - GC – Remodel
95647 - HVAC
96053 - Home Furnishing Installation
96409 - Insulation
96410 - Insulation – Mechanical Installation
96611 - Interior Decorators
97047 - Landscape
97447 - Masonry
97650 - Metal Erection – Decorative
97655 - Metal Erection – Structural
98304 - Painting – Exterior
98305 - Painting – Interior
98344 - Paper Hanger
98449 - Plastering & Stucco
98482 - Plumbing – Commercial
98483 - Plumbing – Residential
98636 - Refrigeration Systems and Equipment
98677 - Roofing – Commercial
98679 - Roofing – Residential
98705 - Sand Blasting
98777 - Commercial Tenant Improvement
98806 - Septic Tank – Installation/Service/Repair
98820 - Sewer Mains
98884 - Sheet Metal
98967 - Siding an Decking
98993 - Sign Erection – Repair/Installation
99321 - Street/Road Paving and Repair
99505 - Swimming Pool Cleaning
99507 - Swimming Pool Installation
99650 - TV Radio Receiving Set Installation/Service/Repair
99746 - Tile and Marble Installation
99777 - Tree Trimming
99946 - Water Mains Connections
99969 - Welding
99975 - Window Cleaning
99999-C - Remodel – Commercial
99999-R - Remodel – Residential
Other - Please Provide Details in Notes
Fourth Class Code Gross Receipts
Other Information
Years of Experience in your Trade
*
Number of years this Business has been operating
*
Insurance Limits
Please specify below if you have any special requirements for minimum/maximum coverage limits
Number of Field Employees
*
Employee Payroll
*
Subcontractor/1099 costs
*
Any other notes or requests?
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