WRAP UP LIABILITY FORM Wrap Up Liability Form Name of insured Address Address Address Address City City Province Province Zip code Zip code Email Description of project Third party surrounding property details North South East West Hard costs ($) Length of project (in months) Completed operations 12 months 24 months Limit ($) Deductible ($) Years in business Years of experience Did the insured had a claim in the last 5 years? Yes No Loss record Date of claim Amount ($) Cause plus1 Add a claim minus1 Remove claim Deposit premium Minimum premium Adjustable rate Subject to Wrap Up Wording USA Work, Sales & Jurisdiction Exclusions Terrorism / Data / Asbestos Exclusions Comments Email Send
