Roofers Insurance Application

Submission of this information does not represent a binding of any insurance contract or agreement. Additional information may be required in order to get an accurate quote of insurance.

Business Details

Applicant Information:

Are you applying as an:(Required)

Business Name:

Full Legal Business Name:(Required)

Principal(s) Name(s):(Required)

Subsidiaries, Partners, or Joint Ventures (if applicable):

Please confirm that all the following statements are accurate before proceeding:

No insurance has been declined, canceled, or non-renewed.
No claims have been made for the business, properties, or partners.
There are no known situations that could result in a claim.
No professional disciplinary actions involve the company or staff.
No other businesses require coverage.
No members have criminal convictions or ties to failed companies.
No bankruptcies involve the business or its members.

Confirmation:(Required)

I confirm all the above statements are accurate.

3. Contact Information:

Phone

Business Address

Street Address City Province Postal Code

Website Address (if available):

Operational Information

4. Experience:

Number of years your business has been in operation:(Required)

Number of years of experience in roofing:(Required)

Describe the work experience of the principals or key personnel:(Required)

Operations and Receipts

5. Types of Roofing Work:

Please enter the amount of revenue per year for each service provided. If you do not do the service please click work not performed. If you are just starting please put an estimated amount you expect to generate.

Hot – Built‐up Roofing ‐ Revenue:

Hot – Built‐up Roofing work not performed

work not performed

Hot Mop ‐ Revenue:

Hot Mop work not performed

work not performed

Hot Air Membrane ‐ Revenue:

Hot Air Membrane work not performed

work not performed

Torch on Membrane ‐ Revenue:

Torch on Membrane work not performed

work not performed

Cold Shingle, Metal Roofing ‐ Revenue

Cold Shingle, Metal Roofing work not performed

work not performed

Cold Membrane & EPDM ‐ Revenue:

Cold Membrane & EPDM work not performed

work not performed

Other Work – Revenue:

Describe other type of work performed:

What Percentage of All Work is – Please enter the percentage. :

Residential

Please enter a number less than or equal to 100.

Commercial

Please enter a number less than or equal to 100.

Industrial

Please enter a number less than or equal to 100.

Total:

Totals:

Hot Work:

Cold Work:

Other:

6. Geographical Range of Operations:

Work performed in Canada:(Required)

Work performed in the United States:

% (Indicate NIL if not applicable)

Work performed in other countries if any:

Job Details

7. Describe Hot Air Membrane Process

7. Describe Hot Air Membrane Process:(Required)

8. Percentage Split of Work:

New Construction:(Required)

Re-Roofing & Repairs:(Required)

9. Any other off-premises work or operations (e.g., sheet metal)? Describe:

10. Does your business engage in the removal & disposal of asbestos (in any form)?

10. Do you engage in the removal & disposal of asbestos (in any form)?(Required)

Yes

If Yes, provide full details:

Safety and Training

11. Safety Program:

Do you have a safety program for new employees?(Required)

Yes

Do you provide ongoing training for all employees?(Required)

Yes

12. Fire Prevention Measures:

Do you do any work that generates heat or flame?

Yes

Describe measures to prevent fire at job sites (including number and type of fire extinguishers):(Required)

Are portable smoke detectors used?(Required)

Yes

Are spray-on fire retardants used?(Required)

Yes

Is smoking prohibited on roofs?(Required)

Yes

Is a supervisor present during operations involving hot equipment or torches?(Required)

Yes

Provide details on propane tank storage, maintenance, and safe handling:(Required)

Are only trained personnel allowed to handle propane tanks?(Required)

Yes

Are all propane tanks equipped with approved, operational safety valves?(Required)

Yes

Are torch system manufacturers’ recommendations followed?(Required)

Yes

Are roofing material manufacturers’ recommendations followed?(Required)

Yes

Are hot trowels used for finish work around details instead of torches?(Required)

Yes

Are torch stands used?(Required)

Yes

Is each torch equipped with a functioning ULC-listed regulator?(Required)

Yes

Is equipment fitted with operational pressure gauges?(Required)

Yes

Are hot air welders or electric heat seaming devices used?(Required)

Yes

13. Water Damage Prevention:

Describe measures to prevent water damage during work (e.g., covering roof areas):(Required)

Operations Review

14. Work Inspections:

Are all jobs inspected at the end of each day and upon completion?(Required)

Yes

15. Specialized Operations

Do you engage in the following? (Check all that apply) OR None of the Above #10 if Nothing:

1. Structural and Foundation Work:

Structural Work (e.g., framing, load-bearing modifications)

Excavation, Foundation Work, or Waterproofing

Underpinning or Shoring

2. Underground and Heavy Construction

Underground Work (Utilities, Pipelines, Sewers

Bridge, Tunnel, or Dam Construction

Raising or Moving of Buildings

3. Specialized Systems and Insulation

Elevator/Escalator Work

Alarm or Sprinkler System Installation

Spray Foam Insulation

4. Hazardous or High-Risk Activities

Blasting, Use of Explosives

Handling or Removal of Hazardous Materials (e.g., Asbestos, Lead,)

Crane Operations or Heavy Equipment Rental/Operation

Use of Drones or Robotics

Oil Tank Work

Work Which Requires any Licensing

Do You Own or Operate Any Watercraft or Airplanes

5. Elevated and Specialty Locations

Work Inside High-Rise Buildings Over 3 Stories

Exterior Work Above 3 Stories

Work at Amusement Parks or Stadiums

Work at Airports, Nuclear Facilities, Offshore Sites, Gas/Oil Facilities, or Mines

6. Heat or Flame-Generating Work

Do You Perform Any Work That Generates Heat or Flame?

7. Public and Institutional Work

Work at Public or Private Playgrounds

Work at Schools or Daycares

8. Seasonal or Location-Specific Work

Snow Removal Work

Work Outside of Canada

Work Using Watercraft or Airplanes

9. Design or Architectural Work

Design, Engineering or Architectural Work

10. None of the Above(Required)

None of The Above Activities Are Engaged In (1-9)

Specialized Operation Description

Describe the type of work done, how much it accounts for your business % wise and any precautions.

What is the average revenue or value of a typical job or project your business completes(Required)

Average Job Size Including Average Contract Value and Type of Work

What is the largest revenue or value of a job or project your business has completed?(Required)

Largest Job Size Including Largest Contract Value and Type of Work

19. Are all operations conducted in conformity with Standard Industry Practices? Yes / No(Required)

Yes

Employment and Subcontractors

20. Employees:

Number of Full-Time Employees:(Required)

Number of Part-Time Employees:

Number of Clerical Employees:

Total Payroll: $(Required)

Are all employees covered under WSIB?(Required)

Yes

If No, provide details for non-covered employees (occupation/number/payroll):(Required)

21. Subcontractors:

Do you subcontract any work?(Required)

Yes

Estimated Subcontracted Receipts: $(Required)

How Much of Your Annual Revenue is Subcontracted Out

Describe subcontractor work:(Required)

Describe All Work Performed by sub-contractors

Are formal contracts used with sub-contractors?(Required)

Yes

Do contracts include a hold-harmless clause in your favor?(Required)

Yes

Are Certificates of Insurance obtained from all subcontractors confirming at least $2 million in liability insurance?(Required)

Yes

Other Exposures

22. Non-Owned Automobile Use:

Number of employees using their automobile for business purposes:

Regularly:(Required)

Occasionally:(Required)

Estimated annual cost of hired automobiles: $(Required)

(this is the cost of renting vehicles for hire)

Coverages Required

1. Commercial General Liability (CGL)(Required)

$2M

$5M

$10M

Protects contractors from financial losses if a third party gets hurt or property is damaged because of their work. It covers medical bills, legal fees, and repair costs for accidents like a client tripping over tools or a damaged window during a project. However, it doesn’t cover injury to employees or owners or fixing poor workmanship.

2. Tools Coverage (Optional):

Not Required

Total Value of Tools: $

Protects your tools if they’re stolen, damaged, or lost. It helps cover the cost of repair or replacement, whether your tools are taken from a job site or accidentally broken during work. However, it doesn’t cover normal wear and tear or intentional damage. Coverage is usually on an actual cash value basis. Usually will not pay more than $1,500 per item.

3. Equipment Coverage(Optional):

Not Required

Make:

Model:

Description:

Insured Value: $

Protects larger equipment, like machinery or specialized gear, from damage, theft, or loss. It helps cover repair or replacement costs if your equipment is stolen, damaged in an accident, or affected by events like fire or vandalism. However, it doesn’t cover wear and tear or mechanical breakdowns. Coverage is usually on actual cash value basis. Requires info about each piece such as serial, make and model of each equipment to be insured.

4. Installation Floater(Optional):

Not Required

Installation Floater Limits:

$25,000

$50,000

$100,000

Protects materials, equipment, and supplies while they’re being installed or in transit to the job site. It covers losses from theft, damage, or unexpected events like fire during the installation process. However, it doesn’t cover faulty workmanship or design flaws. This coverage ensures you’re not out of pocket if something happens to your materials before the project is complete

5. Pollution Liability Coverage(Optional):

Not Required

Pollution Liability Limits:

$1M

$2M

$5M

Protects your business from claims related to pollution caused by your work, like spills, leaks, or contamination. It covers cleanup costs, legal fees, and damages if the pollution harms people, property, or the environment. However, it doesn’t cover intentional violations or long-term environmental issues. Typically requires a separate policy with a speciality insurance company.

If Yes, provide details of operations involving hazardous materials or pollutants:

6. Employee Dishonesty Coverage(Optional):

Not Required

Employee Dishonesty Limits

$25,000

$50,000

$100,000

Protects your business if an employee steals money, property, or other assets. It helps cover financial losses from theft and fraud committed by your staff. However, it does not cover mistakes, errors, or negligence, nor does it provide protection for dishonest acts committed by business owners, partners, or executives.

7. Errors & Omissions (E&O) Coverage (Optional):

Not Required

E&O Limits:

$500,000

$1M

$2M

Protects your business if a client claims you made a mistake, gave bad advice, or didn’t deliver as promised. It covers legal fees, settlements, and damages related to professional negligence or missed deadlines. However, it doesn’t cover intentional wrongdoing or physical injuries. This coverage is essential for professionals who provide advice or services, helping protect against costly disputes. Typically requires a separate policy.

8. Non-Owned Auto Liability(Optional):

Not Required

Non-Owned Auto Liability Limits

$1M

$2M

$5M

Protects your business against liability claims arising from employees or others driving their personal vehicles for business purposes. It does not cover damage to the personal vehicle itself.

9. Umbrella or Excess Liability Coverage (Optional):

Not Required

Umbrella/Excess Limits:

$2M

$5M

$10M

Provides additional liability coverage beyond the limits of your primary insurance policies, protecting your business against large claims or lawsuits.

10. Business Interruption Coverage Due to Insured Risks? (Optional):

Not Required

Include

Provides additional liability coverage beyond the limits of your primary insurance policies, protecting your business against large claims or lawsuits.

11. Cyber Liability (Optional):

Not Required

11. Cyber Liability (Optional):

$1M

$2M

$5M

Protects your business against financial losses from data breaches, cyberattacks, and other digital threats, covering costs like notification, legal fees, and recovery, but does not cover intentional acts by employees or prior known vulnerabilities.

Roofers Insurance Application

Business Details

Applicant Information:

Business Name:

3. Contact Information:

Operational Information

4. Experience:

Operations and Receipts

5. Types of Roofing Work:

What Percentage of All Work is – Please enter the percentage. :

Totals:

6. Geographical Range of Operations:

Job Details

7. Describe Hot Air Membrane Process

8. Percentage Split of Work:

9. Any other off-premises work or operations (e.g., sheet metal)? Describe:

10. Does your business engage in the removal & disposal of asbestos (in any form)?

Safety and Training

11. Safety Program:

12. Fire Prevention Measures:

13. Water Damage Prevention:

Operations Review

14. Work Inspections:

15. Specialized Operations

Employment and Subcontractors

20. Employees:

21. Subcontractors:

Other Exposures

22. Non-Owned Automobile Use:

Coverages Required

Toronto

Mississauga