Subcontractor Company Information

Insurance

Must meet the following requirements:

• General aggregate per project

• Certification issued on standard ACORD form

• Coverage supplied on a primary and non-contributory basis (GL & Auto)

• Waiver of subrogation in favor of additional insureds (GL, Auto & W/C)

• G&G Enterprises Construction Corp shown as Certificate holder

• G&G Enterprises Construction Corp, project owner (and lender if required) shown as additional insured

• Cancellation requires 30 days written notice

General Liability coverage minimums:

Automobile Liability coverage minimums:

Excess or Umbrella coverage minimums:

Workers Compensation minimums:

**Current Insurance Certificate showing your limits must be attached** Please do not reference G&G Enterprises Construction Corp

Safety

Does your firm hold site safety meetings for?

Legal

Taxpayer Identification Number

Under penalties of perjury, I certify that:

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1. The number shown on this form is my correct taxpayer identification number and

2. I am not subject to backup withholding because:(a) I am exempt from backup withholding, or(b) I have not been notified by the IRS. I am subject to backup withholding as a result of a failure to report all interest or dividends, or(c) the IRS has notified me I am no longer subject to withholding; and

3. I am a U.S. citizen or other US person.

Thanks for submitting!