AMH GROUP Commercial Policy Client Sign-off

Please confirm the expected/requested coverage for your business (Please check all that apply) *

Vehicle Insurance Information (Desired Vehicle Insurance Coverage)

Deductibles
 1002505007501,000
Complehensive
Collission
Additional Coverage Options

I accept responsibility to read and understand my insurance policy/policies. This may include, but is not limited to my policy billing invoices, declaration page, amendments, and any other policy documents I would expect to received as part of my insurance coverage. I am aware my insurance agent/agency (AMH GROUP/Insurance & Risk Management, LLC) is available to address and explain any questions or concerns I may have regarding my policy or coverage. My signature on the policy application is my acceptance of the policy and its terms as written in the policy.

GENERAL LIABILITY/BOP COVERAGE: Subcontractors (individuals or companies I have contracted work to, but are not employed by my company) are required to provide Certificate of Insurance. Less than 20% of my company annual revenue is generated from work that I subcontract to another individual or company. Subcontractors are required to carry insurance limits equal to or greater than the coverage for my company, and are not allowed to work without proof of coverage in-force. Subcontractors are required to list the my company as an additional insured on their insurance policy and indemnify my company. My company DOES NOT lease employees to or from other employers. I am aware I can request coverage for my business personal property, tools and equipment. It is my responsibility to submit in writing, the items I need coverage for to my agent. Failure to do so may result in my company business personal property, tools, equipment not having coverage.

Owner/Managing Officer (Sign using cursor) *
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