NAME OF PERSON FILLING OUT APPLICATION
(If you don’t know your class codes, Please fill in a brief description of what those employees are doing in each class code description below. In the Payroll section please provide the combined annual payroll for that class code description. If you happen to know if they’re in a lower wage or higher wage class code please include that information as well)
Employee Classification
Class Code Description
Payroll$
(a)ARE YOU SUBCONTRACTING ANYTHING OUT? YesNo (b)IF YES, WHAT PERCENTAGE OF YOUR OVERALL OPERATIONS IS SUBCONTRACTED OUT? (c)WHAT ARE YOU SUBCONTRACTING OUT?
(a) What percentage of your operations are residential versus commercial? Residential vs Commercial (b) What percentage of your operations are remodeling versus new construction? Remodeling vs New Construction (c) What percentage of your operations are interior versus exterior? Interior Exterior (d) Is there any height exposure above 12 feet? YesNo