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CSP Pro Application
Business Name
Explain what you do. Do more than 50% of your sales come from Staging?
Legal Entity (Individual, LLC, Corp)
Year Established
Email
Phone
Contact Name
First
Last
Mailing Address
Street Address
City
State / Province / Region
ZIP / Postal Code
Location Address (if different)
Street Address
City
State / Province / Region
ZIP / Postal Code
Do you have current insurance coverage? Who is your current carrier?
For your business location address please tell us about the building:
Year built
Construction type
Wood Frame
Jointed Masonry
Masonry Non-combustible
Noncombustibles
Burglary alarm and is it centrally monitored?
Yes
No
Fire alarm and is it centrally monitored?
Yes
No
Sprinklers?
Yes
No
Year Updated
Roof
Electric
Plumbing
HVAC
Staging Inventory Address (if different than location address)
Street Address
Address Line 2
State / Province / Region
ZIP / Postal Code
For your business location address please tell us about the building:
Year built
Construction type
Wood Frame
Jointed Masonry
Masonry Non-combustible
Noncombustibles
Burglary alarm and is it centrally monitored?
Yes
No
Fire alarm and is it centrally monitored?
Yes
No
Sprinklers?
Yes
No
Year Updated
Roof
Electric
Plumbing
HVAC
Do you rent any vehicles?
Yes
No
What is the total cost of vehicles rented per year?
What type of vehicles are rented, specifically larger trucks?
What process is used to evaluate driver eligibility for hired autos?
Do you do any work in NY? If so, describe a typical job?
Are you transporting furniture?
Yes
No
Are you hiring movers to transport the furniture?
Yes
No
Website Info:
Do you use a contract?
Yes
No
Total replacement value of all inventory:
Do you use subcontractor agreements for any vendor/subcontractor you bring to the job and do they hold you harmless and add you as additional insured?
Yes
No
Are damages or theft customers' responsibility?
Yes
No
Number of Employees
Full Time
Part Time
Would you like a quote for Workers Compensation?
Yes
No
FEIN #
Executive officer – include or exclude.
Executive Officer – if included please give your annual payroll
Employees – total annual payroll (all employees)
Employees – are they moving furniture or dropping in accessories
Please give description of what employees are doing and their annual payroll
Would you like a quote for Professional Liability (E&O Insurance)?
Yes
No
If you have current professional liability (E&O) what is your retroactive date?
If you are you a member of CSP Pro – please include your CSP Pro membership ID:
Annual Gross Revenue
Staging Inventory
Any claims in the past 3‐5 years?
Yes
No
Where did you hear about us?
Signature
Date
Date Format: MM slash DD slash YYYY
