Questionnaire for Instrumentation Control Engineers

QUESTIONNAIRE FOR ENVIRONMENTAL ENGINEERS AND CONSULTANTS TO DETERMINE ELIGIBILITY FOR P&C BOP (Business Owners Policy)

Note: If the insured answers ‘yes’ to any of the following, they do not qualify.

1. Does the insured perform any of the following services?

a. Asbestos abatement services Yes No

b. Mold abatement services Yes No

2. Doe the insured ever hire and/or supervise subcontractors or contraction operations? Yes No

3. Does the insured dispose of hazardous waste? Yes No

4. Do any of the insureds clients’ projects involve pollution control or environmental investigation or remediation? Yes No

5. Does the insured conduct business in any of the following states?

a. Alaska Yes No

b. Florida Yes No

c. Hawaii Yes No

d. Louisiana Yes No

e. Mississippi Yes No

6. Does the insured perform aviation and/or boating survey Yes No

7. Has the insured been involved in receivership, bankruptcies, tax or credit lien against them in the past five years? Yes No

Please email this completed form to or your underwriter.