Form 81: Tools & Equipment Insurance Application

Section 1: Applicant Information

Company/Business Name

Federal Tax ID

Primary Contact Name

Title

Business Address

City

State

ZIP Code

Phone Number

Email Address

Section 2: Business Details

Type of Contracting Business

Years in Business

Number of Employees

Annual Revenue

Section 3: Equipment Inventory

Important: List all tools, equipment, and materials to be covered. Include purchase date, current value, and replacement cost for each item.

Power Tools & Hand Tools

Item Description	Make/Model	Serial Number	Purchase Date	Purchase Price	Current Value	Replacement Cost





Power Tools & Hand Tools Subtotal:

Heavy Equipment & Machinery

Equipment Description	Make/Model	Serial/VIN	Purchase Date	Purchase Price	Current Value	Replacement Cost




Heavy Equipment Subtotal:

Vehicles & Trailers

Vehicle Description	Make/Model/Year	VIN	Purchase Date	Purchase Price	Current Value	Replacement Cost



Vehicles & Trailers Subtotal:

TOTAL EQUIPMENT VALUE: $______________

Section 4: Storage & Security Requirements

Primary Storage Location

Storage Facility Address

Storage Type

Security Rating

Security Features Present

Deadbolt Locks

Security Lighting

Alarm System

Security Cameras

Perimeter Fencing

Security Guard

Gated Access

24/7 Monitored Service

Section 5: Coverage Options & Premium Calculation

Requested Coverage Types

Theft Coverage

Accidental Damage

Fire & Explosion

Weather Damage

Vandalism

Equipment in Transit

Preferred Deductible

Coverage Limit

Section 6: Claims History

Have you filed any equipment insurance claims in the past 5 years?

If yes, please provide details (Date, Type of Loss, Amount Claimed, Resolution):

Any theft incidents (reported or unreported) in the past 3 years?

If yes, please provide details:

Section 7: Alliance Integration Features

🔗 BuildSuite™ Integration

Enable automatic equipment tracking and inventory management

Automated equipment valuation updates

Real-time replacement cost calculations

💰 Group Purchasing Benefits

Apply Alliance group discount (up to 15% off standard rates)

Streamlined claims processing through Alliance network

Access to preferred repair/replacement vendors

📱 Additional Services

Equipment tracking mobile app

Preventive maintenance alerts

GPS tracking and theft recovery service

Section 8: Additional Information

Special Considerations or High-Value Items (Describe any unique equipment, custom tools, or special circumstances):

Preferred Coverage Start Date

Section 9: Signatures & Submission

Certification: I certify that the information provided in this application is true and complete to the best of my knowledge. I understand that any misrepresentation may void coverage. I authorize Alliance for Contractors to verify this information and process this application.

Applicant Signature

Date

Print Name