• IDAL Insurance Program
  • Application
  • Download Printable Application

IDAL Insurance Application

For questions regarding this, call 866-916-9420.

Applicant Information

Category*
Are you a current member of IDAL?*
Address*

Insurance Information

MM slash DD slash YYYY
Do you perform any work other than what is necessary and Incidental to Decorative Painting, Decorative Plastering, and Wall Stenciling?*
Do you require proof of insurance for all subcontracted employees? (1099 employees)*
Please enter a number from 0 to 100.
During the Past three years has any company ever cancelled, declined, or refused to renew similar coverage?*
Any Claims in the last 3 Years?*
MM slash DD slash YYYY
Do you perform regular/straight painting (painting that is not considered decorative nor base coats to decorative finishes)?
Please enter a number from 0 to 100.
Do you perform any exterior painting?
Please enter a number from 0 to 100.
Disclaimer: the insurance policy excludes any work performed over 6 stories or 72 feet above ground level.

E-Signature

Consent*
*
The applicant represents that the above statements and facts are true and that no material facts have been suppressed or misstated and further acknowledges that the answers provided herein are based on reasonable inquiry and/or investigation.

Completion of this form does not bind coverage. Applicant’s acceptance of the company’s quotation is required prior to binding coverage and policy issuance.

All written statements and materials furnished to the company in conjunction with this application are hereby incorporated by reference into this application and made a part hereof.
MM slash DD slash YYYY
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

© 2022 IDAL

Download Printable Application Form

Secure by Rapid SSL