Name: Wilmore Insurance Agency
Address: 10518 Connecticut Avenue, Kensington, MD, 20895, US
Telephone: (202) 888-7085

Business Name
Address
Street Address City State / Province / Region ZIP / Postal Code
Business Phone
Business Email
Website (If Any)
Name of Business Owner(s)
Indicate Type of Operation
Air Conditioning/Heat
Cleaning Carpets
Carpentry framing
Drywall
Flooring
Plaster/Stucco
Cleaning Office, Residential
Electrical
Interior Painting
Plumbing
Cabinetry
Doors and Windows
Exterior Painting
Landscaping
Tile, Marble Work
Driveway/Sidewalk
Fences
Roofing
Underground Services
Other Business operations not listed above, please explain in the box below
EIN:
When was your company established?
MM slash DD slash YYYY
How many years of experience do you have?
What are your gross annual sales/receipts before expenses?
How many employees do you have? (excluding the owners)
What is your estimated annual payroll?
Who is your existing insurance carrier?
Have you had any losses?
Explain
Date of loss?
MM slash DD slash YYYY
Do you work outside your home state?
If so enter in the space below where and the percentage of work completed outside your home state.
What percent of your work do you subcontract out to others on an annual basis? Example: You take a job to renovate a kitchen but you subcontract the plumbing work to someone else.
What percentage of your work is done in residential settings?
What percentage of your work is done in commercial settings?
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Commercial Application GL/WC

Indicate Type of Operation