Horticultural Proposal Form

Company Name/Trading Name: *

State:

Mobile:

Period of Insurance - From: * at 4pm Local Standard Time

Height Restriction Required:

5m 10m Unrestricted

Estimated annual turnover - next 12 months: *

Number of full time employees: *

Do you engage subcontractors (these are persons who operate their own business and who contract to perform work/services for others)?

Yes No

Have you entered into any contract or agreement under which you have agreed to accept legal liability, other than for your own negligence?

Yes No