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Company Name
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Contact Person
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Street Address
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Zip
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State
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City
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Telephone
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County
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Fax
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Web Address
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E-mail
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How many Inspectors are to be
covered by this policy?
(do not count support staff)
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Year Established
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1)
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Form Of Business
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Other, Please explain
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2)
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Are there branch offices?
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If Yes, Please list addresses, one per line
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Is the Applicant or any other proposed insured
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3)
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a) Owned by, controlled by or act as a Director or Officer of any other
business or organization?
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b) engaged in any other business or employed by any other business or
organization?
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If Yes, please explain
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If YES, what percentage of inspection services are performed for such
business(es)?
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In the past FIVE years has the name of the Applicant been changed or
has any other business been purchased, merged or consolidated with
the Applicant?
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4)
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If Yes, Please explain
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5)
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Please detail the number of partners and staff
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Full Time
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Part Time
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Principals/Partners/Inspectors (owners)
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Professional Staff /Inspectors (non-owners)
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Other Employees (helper/apprentices)
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6)
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Please detail the following for all owners, officers, directors, partners and Inspectors:
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Professional
Qualifications
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Estimated Gross
Annual Income
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Estimated # of
Inspections
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7)
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Please detail annual gross income
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Year
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Estimate for NEXT year
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2009
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Estimate for THIS year
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2008
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2007
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Estimate for LAST year
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8)
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What was the Applicant’s largest fee for an individual inspection job ever done
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What type of inspection was it?
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What is your average fee?
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9)
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Do you takes pictures during your inspection?
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What type of inspection report does the Applicant use? (Select all that apply)
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10)
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11)
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What inspection standards are used
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If Other, please list
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Is the Applicant affiliated with any of these professional home inspection
organizations (Select all that Apply)
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12)
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If Other, Please list the other organization
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13)
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Please list the states where the Applicant performs inspection services:
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Indicate the types of inspections performed and the percentage of gross income derived from each
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14)
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Type of Inspection Performed:
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Residential home inspection – less than 4 units
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Residential home inspection – over 4 units
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Soft Commercial (retail, business parks, office buildings)
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Lead
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Code
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Mold/Indoor Air Quality
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Septic/Sewer
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Pools/Spa's
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Seller Inspections
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Green Certification
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Total (Must equal 100%)
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15)
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Indicate the percentage of inspections performed for the following types of clients
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Individual purchasers
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Mortgage lenders
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Municipalities
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Governmental agencies including, but not limited to HUD and FHA
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