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Trail Builders Application Form

Applicant & Business Information

Applicant Name *

Company Name (if applicable)

Street Address *

Apartment, suite, etc

City *

Province *We provide insurance services only within Canada. We are unable to assist customers located in the United States.

Postal Code *

Company website (if applicable)

Year Business Was Established *(for startups, enter years of experience)

Describe Your Experience and Operations, Including Any Trail Building, Heavy Machinery, Engineering or Landscaping, Education or Training? *0 / 250

Loss History

Any claims within the last 5 years? *YesNo

If yes, please describe: *

Do you currently have insurance? *YesNo

If yes, please attach current policy documents *

Drag and Drop (or) Choose Files

Has your insurance ever been cancelled or refused? *YesNo

If yes, please provide details: *

Risk Info

Gross Revenue for Operations (12month forecast CAD): *

Do you have operations outside of Canada? *YesNo

If yes, please list all countries where you have operations/contracts. *

How many years of trail-building experience do you have? *

Do employees have Basic First Aid Training? *YesNo

Do you utilize any subcontractors? *YesNo

If yes, please provide a statement on minimum experience criteria with your contractors. Years of experience, certifications, etc. *

Do you assume liability under hold harmless (HHA) agreements? *YesNo

If yes, “What percentage of the Applicant’s work is covered under a project specific wrap-up liability policy?” box opens to respond with 0-100% numeric only. *

Does the business take part in any work other than trail building? (ex. Snow removal, forestry, mining, oil and gas) *YesNo

Coverage

Liability limit required? *

Describe your specific requirements to hold more than $5m limits *

Do you need any Tenant Legal Liability? *YesNo

Do you have any employees? *YesNo

If yes, how many? *

Do you utilize any vehicles or machinery that are not owned by you or your business? *YesNo

If yes, how many days per month do you use a vehicle not owned/leased by you? *

Is Forest Fire Fighting expense coverage required? *YesNo

Does the business provide any Pre-Construction Design Consultant services? *YesNo

If yes, do you require coverage for Professional Liability? *YesNo

Optional Coverages

Do you require Tool Floater “equipment” coverage? Note, we offer separate property coverage for heavy machinery. Ex: excavators and trailers. *YesNo

Enter total value (Tool Floater subject to any one item max $2,500 value) *

Do you require Rented, Leased & Borrowed Equipment (short term - max 30 day rental equipment) coverage? *YesNo

If yes, maximum value at any one point in time for rented, leased and borrowed equipment: *

Does the Applicant require Miscellaneous Articles Floater coverage? *YesNoOptional coverage for business use items that may or may not be covered elsewhere and are infrequently used by the business) Ex: E-bike for site visits, survey tools, radios and computers

Enter total value *

Does the Applicant require to schedule Contractor's Equipment (over 30 days): *YesNo

Make, model, year, approx. replacement value, serial number *

Do you require commercial property coverage? Ex: Building or temporary storage facility *YesNo

Do you require crime coverage (Comprehensive Dishonesty, Destruction, Disappearance and Forgery) *YesNo

Do you require Cyber coverage (recommended if you take money through a website or store clients' information) *YesNo

Confirmation

By hitting submit I confirm that the information I have provided is true and accurate to the best of my knowledge and understand that it will be used by licensed brokers and underwriters to prepare an insurance quote.

Less risk
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Our recommendations can help lower the price of insurance for cycling businesses and everyday bike enthusiasts here across Canada.

British Columbia

997 Seymour St #250
Vancouver, BC V6B 3M1

BC Corporate License – LIC-2024-0049497-R01

Alberta

5005 Dalhousie Dr NW Unit 175 #1441
Calgary, AB T3A 5R8

AB License – K-2200253-11394034-2024

Ontario

605 James St N Suite 200
Hamilton, ON L8L 1J9

ON Corporate License – 6076

contact@bicyclebroker.ca
(+1) 877.621.6940

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