


| • | Completed Accord Application, Tax ID number or social security number |
| • | 3 Year Loss information or letter of no loss on applicant's letterhead |
| • | Completed ACORD Workers Compensation Application |
| • | Copy of experience rating (if applicable) |
| • | Air Conditioning/Heating |
| • | Artisan Contractors |
| • | Auto Repair |
| • | Barber Shops |
| • | Churches - No Day Care |
| • | Building Operations |
| • | Apartment Operations |
| • | Limousine Companies |
| • | Hotels and Motels |
| • | Grocery Stores |
| • | Theaters |
| • | Service Station |
| • | Contractors Permanent Yards |
| • | Retail/Wholesale Stores |
| • | Janitorial Service by contract |
| • | Tent Erection |
| • | Mobile Home Parks |
| • | Plumbing NOC |
| • | Carpenting - Shop |
| • | Electrical Wiring |
| • | Door Installation |
| • | Painting |
| • | Paper Hanging |
| • | Concrete or Cement driveways, sidewalks, curbs |
| • | Parking Lot Striping |
| • | Concrete or Cement driveways, sidewalks, curbs |
| • | Parking Lot Striping |
| • | Office Machine or Appliance Installers |


