ACORD 186 Instructions


 

Universal wording updates to improve clarity and intent were made to all FIG text for this form on 06/30/2009.
Section Name Field Name Field and/or Section Description
TITLE ACORD 186 (2009/03) Contractors Supplement The title of the form. ACORD 186, Contractors Supplement, is used as a supplement to ACORD 126,Commercial General Liability Section, or ACORD 160, Business Owners Policy Application when applying forcommercial insurance for the following contractor classes: * Air Conditioning and Heating * Cabinetmakers * Carpentry * Electrical Wiring * Excavation and Grading of Land or Septic Installation * Insulation * Landscaping * Masonry * Painting * Plumbing * Roofing
IDENTIFICATION Agency Customer ID Enter identifier: The customer’s identification number assigned by the producer (e.g. agency or brokerage).
IDENTIFICATION Date Enter date: The month/day/year on which the form is completed. (MM/DD/YYYY)
IDENTIFICATION Agency Enter text: The full name of the producer/agency.
IDENTIFICATION Named Insured(s) Enter text: The named insured(s) as it/they will appear on the policy declarations page.
IDENTIFICATION Policy Number Enter identifier: The identifier assigned by the insurer to the policy, or submission, being referenced exactly as it appears on the policy, including prefix and suffix symbols. If required for self-insurance, the self-insured license or contract number.
IDENTIFICATION Effective Date Enter date: The effective date of the policy. The date that the terms and conditions of the policy commence.
IDENTIFICATION Carrier Enter text: The insurer’s full legal company name(s) as found in the file copy of the policy. Use the actual name of the company within the group to which the policy has been issued. This is not the insurer’s group name or trade name.
IDENTIFICATION NAIC Code Enter code: The identification code assigned to the insurer by the NAIC.
IDENTIFICATION Type of Contractor Enter text: The contractor class as described in ACORD 126 or ACORD 160.
IDENTIFICATION Years Experience Enter number: The contractor’s number of years of experience.
IDENTIFICATION Full Time Enter number: The number of full time employees.
IDENTIFICATION Part Time Enter number: The number of part time employees.
IDENTIFICATION Contractor’s License Number Enter identifier: The state or local license number for the applicant.
IDENTIFICATION Owner Check the box (if applicable): Indicates the license holder is the owner of the business.
IDENTIFICATION Officer Check the box (if applicable): Indicates the license holder is an officer of the business.
IDENTIFICATION Employee Check the box (if applicable): Indicates the license holder is an employee of the business.
IDENTIFICATION Other Check the box (if applicable): Indicates the license holder has a relationship with the business other than those listed.
IDENTIFICATION Describe Other Enter text: The relationship the license holder has with the business.
 

Section Name Field Name Field and/or Section Description
IDENTIFICATION % Residential Enter percentage: The percentage of work that is residential.
IDENTIFICATION % Commercial Enter percentage: The percentage of work that is commercial.
IDENTIFICATION % New Construction Enter percentage: The percentage of work that is new construction.
IDENTIFICATION % Remodel Enter percentage: The percentage of work that is remodeling.
IDENTIFICATION Gross Receipts Enter amount: The total annual gross sales or receipts.
IDENTIFICATION Payroll Enter amount: The total annual payroll of the business in whole dollars.
IDENTIFICATION Minimum GL Limits Occurrence Enter limit: The general liability, each occurrence limit amount. Any questions about appropriate limits or applicable policy coverage(s) should be answered by the issuing insurer(s). As used here, this is the minimum limit.
IDENTIFICATION Minimum GL Limits Aggregate Enter limit: The general liability, general aggregate limit amount. Any questions about appropriate limits or applicable policy coverage(s) should be answered by the issuing insurer(s). As used here, this is the minimum limit.
IDENTIFICATION Total Cost of Subcontracted Work Past Year Enter amount: The total cost of subcontracted work for the past 12 months.
IDENTIFICATION Explosive Environments Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Any work done in or around Explosive Environments (Paints, Solvents, etc.)?
IDENTIFICATION Installation of Emergency Back-up Equipment. Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Any work done in or around Installation of Emergency Back-up Equipment?”.
IDENTIFICATION Airport Construction or Repair. Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Any work done in or around Airport Construction or Repair?”.
IDENTIFICATION Dam, Bridge, or River Related Construction. Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Any work done in or around Dam, Bridge or River Related Construction?”.
IDENTIFICATION Petrochemical Plants. Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Any work done in or around Petrochemical Plants?”.
IDENTIFICATION Fire Alarm or Automatic Sprinkler Design, Install or Repair. Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Any work done in or around Fire Alarm or Automatic Sprinkler Design, Install Repair?”.
IDENTIFICATION Burglar Alarm Design, Install or Repair. Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Any work done in or around Burglar Alarm Design, Install or Repair?”.
IDENTIFICATION High Voltage (over 480 volts) Or High Amperage. Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Any work done in or around High Voltage (over 480 volts) or High Amperage?
 

Section Name Field Name Field and/or Section Description
IDENTIFICATION Major Electrical Control Panels. Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Any work done in or around Major Electrical Control Panels?”.
IDENTIFICATION Nuclear Plants. Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Any work done in or around Nuclear Power Plants?”.
IDENTIFICATION Hospitals. Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Any work done in or around Hospitals?”.
IDENTIFICATION Power Plants. Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Any work done in or around Power Plants?”.
IDENTIFICATION Traffic Signal Works. Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Any work done in or around Traffic Signals?”.
IDENTIFICATION Oil or Gas Refiners. Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Any work done in or around Oil or Gas Refineries?”.
IDENTIFICATION Power Lines. Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Any work done in or around Power Lines?”.
GENERAL INFORMATION Swimming Pools. Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Any work done in or around Swimming Pools?”.
GENERAL INFORMATION Hot or Live Wires. Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Any work done in or around Hot or Live Wires?”.
GENERAL INFORMATION Land Fill. Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Any work done in or around Land Fills?”.
GENERAL INFORMATION Hazardous Material Abatement. Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Any work done in or around Hazardous Material Abatement?”.
GENERAL INFORMATION Other Exposure Description Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Any other types of exposures?”.
GENERAL INFORMATION Other Exposure. Enter text: The description of the exposure.
GENERAL INFORMATION Does applicant draw plans, designs, or specification for others? Enter Y for a “Yes” response. Input N for “No” response. The response to the question, “Does applicant draw plans, designs or specifications for others?”.
GENERAL INFORMATION Do any operations include blasting or utilize or store explosive material? Enter Y for a “Yes” response. Input N for “No” response. The response to the question, “Do any operations include blasting or utilize, or store explosive material?”.
GENERAL INFORMATION Do any operations include excavation, tunneling, underground work or earth moving? Enter Y for a “Yes” response. Input N for “No” response. The response to the question, “Does any operation involve excavation, tunneling, underground work or earth moving?”.
 

Section Name Field Name Field and/or Section Description
GENERAL INFORMATION Is there a formal, written safety and security policy in effect? Enter Y for a “Yes” response. Input N for “No” response. The response to the question, “Is there a formal, written safety and security policy in effect?”.
GENERAL INFORMATION Any demolition or wrecking work? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Any demolition or wrecking work?”.
GENERAL INFORMATION Any use of cranes? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Any use of cranes?”.
GENERAL INFORMATION Do your subcontractors carry coverages or limits less than yours? Enter Y for a “Yes” response. Input N for “No” response. The response to the question, “Do subcontractors carry coverages or limits less than applicant?”.
GENERAL INFORMATION Are subcontractors allowed to work without providing you with a certificate of insurance? Enter Y for a “Yes” response. Input N for “No” response. The response to the question, “Are subcontractors allowed to work without providing you with a certificate of insurance?”.
GENERAL INFORMATION Does applicant lease equipment to others with or without operators? Enter Y for a “Yes” response. Input N for “No” response. The response to the question, “Does applicant lease equipment to others with or without operators?”.
GENERAL INFORMATION Any boats, docks, floats owned or leased? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Any boats, docks, floats owned or leased?”.
SPECIFIC CONTRACTOR INFORMATION Any advertising signs away from premises? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Any advertising signs away from premises?”.
SPECIFIC CONTRACTOR INFORMATION Does an employee of the applicant have direct oversight of each jobsite in progress? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Does an employee of the applicant have direct oversight of each jobsite in progress?”.
SPECIFIC CONTRACTOR INFORMATION Radius of operations Enter number: The radius of operations for an employee having direct oversight of job sites in progress.
SPECIFIC CONTRACTOR INFORMATION Do you lease employees to or from other employees? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Do you lease employees to or from other employees?”.
SPECIFIC CONTRACTOR INFORMATION Any operation or owned, leased or rented property not covered by this policy? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Any operation or owned, leased or rented property not covered by this policy?”.
SPECIFIC CONTRACTOR INFORMATION Any product manufactured or sold under the applicant’s name? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Any product manufactured or sold under the applicant’s name?”.
SPECIFIC CONTRACTOR INFORMATION Any boiler work done? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Any boiler work done?”.
SPECIFIC CONTRACTOR INFORMATION Any asbestos removal done? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Any asbestos removal done?”.
 

Section Name Field Name Field and/or Section Description
SPECIFIC CONTRACTOR INFORMATION Is dust collection system present? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Is dust collection system present?”.
SPECIFIC CONTRACTOR INFORMATION Does spray booth meet NFPA standards? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Does spray booth meet NFPA standards?”.
SPECIFIC CONTRACTOR INFORMATION Any roofing done? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Any roofing done?”.
SPECIFIC CONTRACTOR INFORMATION What percentage? Enter percentage: The percentage of work that is roofing work.
SPECIFIC CONTRACTOR INFORMATION Any shop work done? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Any shop work done?”.
SPECIFIC CONTRACTOR INFORMATION Any renovation work done? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Any renovation work done?”.
SPECIFIC CONTRACTOR INFORMATION What percentage? Enter percentage: The percentage of work that is renovation work.
SPECIFIC CONTRACTOR INFORMATION Any gutting of interior load bearing walls? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Any gutting of interior load bearing walls?”.
SPECIFIC CONTRACTOR INFORMATION Any underground cable work? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Any underground cable work?”.
SPECIFIC CONTRACTOR INFORMATION Maximum Depth of excavation & grading of land & septic installation Enter number: The maximum depth of excavation & grading of land & septic installation
SPECIFIC CONTRACTOR INFORMATION Water Lines Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Is there any excavation of water lines?”.
SPECIFIC CONTRACTOR INFORMATION Sewer Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Is there any excavation of sewers?”.
SPECIFIC CONTRACTOR INFORMATION Septic Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Is there any excavation or installation of septic systems?”.
SPECIFIC CONTRACTOR INFORMATION Basements Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Is there any excavation of basements?”.
SPECIFIC CONTRACTOR INFORMATION Other Type of Excavation Description Enter text: The description of the type of excavation work being done.
SPECIFIC CONTRACTOR INFORMATION Other Type of Excavation. Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Other Type of Excavation?”.
SPECIFIC CONTRACTOR INFORMATION Any work done in streets or roads? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Any work done in streets or roads?”.
 

Section Name Field Name Field and/or Section Description
SPECIFIC CONTRACTOR INFORMATION Are excavations marked and guarded at end of day? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Are excavations marked and guarded at end of day?”.
SPECIFIC CONTRACTOR INFORMATION Are utilities staked before the start of every dig? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Are utilities staked before the start of every dig?”.
SPECIFIC CONTRACTOR INFORMATION If telephone inquiries are made, is a log maintained showing date, time, person spoken to, plot # and map # referred to? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “If telephone inquiries are made, is a log maintained showing date, time, person spoken to, plot # and map # referred to?”.
SPECIFIC CONTRACTOR INFORMATION Any snowplowing? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Any snowplowing done?”.
SPECIFIC CONTRACTOR INFORMATION Is shoring work done in accordance with standards? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Is shoring work done in accordance with standards?”.
SPECIFIC CONTRACTOR INFORMATION Any removal? (Insulation) Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Any insulation removal?”.
SPECIFIC CONTRACTOR INFORMATION Any encapsulation or removal of asbestos? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Any encapsulation or removal of asbestos?”.
SPECIFIC CONTRACTOR INFORMATION Has applicant applied or installed any exterior insulation or finishing, or any exterior insulation finishing systems (EIFS) related product or materials in the past? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Has applicant applied or installed any exterior insulation or finishing, or any exterior insulation finishing systems (EIFS) related product or materials in the past?”.
SPECIFIC CONTRACTOR INFORMATION Have you been involved with the application or installation of material that is directly in contact with EIFS, such as windows, doors, paint caulk or flashing materials? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Have you been involved with the application or installation of material that is directly in contact with EIFS, such as windows, doors, paint caulk or flashing materials?”.
SPECIFIC CONTRACTOR INFORMATION If you are a general contractor or subcontractor using subcontractors, have you managed projects or operations using EIFS or EIFS related products as the exterior finish? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “If you are a general contractor or subcontractor using subcontractors, have you managed projects or operations using EIFS or EIFS related products as the exterior finish?”.
 

Section Name Field Name Field and/or Section Description
SPECIFIC CONTRACTOR INFORMATION Have you had any EIFS related losses? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Have you had any EIFS related losses?”.
SPECIFIC CONTRACTOR INFORMATION Any grading of land or excavation work done? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Any grading of land or excavation work done?”.
SPECIFIC CONTRACTOR INFORMATION What percentage? Enter percentage: The percentage of work done that is grading of land or excavation.
SPECIFIC CONTRACTOR INFORMATION Any spraying of bushes, lawns, etc with pesticides, herbicides, or fertilizers? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Any spraying of bushes, lawns, etc with pesticides, herbicides, or fertilizers?”.
SPECIFIC CONTRACTOR INFORMATION Any tree trimming work done? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Any tree trimming work done?”.
SPECIFIC CONTRACTOR INFORMATION What percentage? Enter percentage: The percentage of work done that is tree trimming.
SPECIFIC CONTRACTOR INFORMATION Any work done during “off season” months? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Any work done during “off season” months?”.
SPECIFIC CONTRACTOR INFORMATION Any snowplowing done? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Any snowplowing done?”.
SPECIFIC CONTRACTOR INFORMATION What percentage? Enter percentage: The percentage of work done that is snow plowing.
SPECIFIC CONTRACTOR INFORMATION Do you excavate also? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Do you excavate also?”.
SPECIFIC CONTRACTOR INFORMATION Any retaining walls built? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Any retaining walls built?”.
SPECIFIC CONTRACTOR INFORMATION Any mix-in-transit? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Any mix-in-transit?”.
SPECIFIC CONTRACTOR INFORMATION Any work involving load-bearing walls? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Any work involving load-bearing walls?”.
SPECIFIC CONTRACTOR INFORMATION Any basement work? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Any basement work?”.
IDENTIFICATION Agency Customer ID Enter identifier: The customer’s identification number assigned by the producer (e.g. agency or brokerage).
SPECIFIC CONTRACTOR INFORMATION (continued) Painting Inside Percentage Enter percentage: The percentage of painting work that is inside.
 

Section Name Field Name Field and/or Section Description
SPECIFIC CONTRACTOR INFORMATION (continued) Painting Outside Percentage Enter percentage: The percentage of painting work that is outside.
SPECIFIC CONTRACTOR INFORMATION (continued) Any work done above 2 stories? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Any work done above 2 stories?”.
SPECIFIC CONTRACTOR INFORMATION (continued) Any scaffolding used? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Any scaffolding used?”.
SPECIFIC CONTRACTOR INFORMATION (continued) To what height? Enter number: The height of scaffolding used.
SPECIFIC CONTRACTOR INFORMATION (continued) Any painting of tanks, water or gas? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Any painting of tanks, water or gas?”.
SPECIFIC CONTRACTOR INFORMATION (continued) Any painting of bridges or towers? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Any painting of bridges or towers?”.
SPECIFIC CONTRACTOR INFORMATION (continued) Any exterior spray painting? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Any exterior spray painting?”.
SPECIFIC CONTRACTOR INFORMATION (continued) What percentage? Enter percentage: The percentage of painting work that is exterior spray painting.
SPECIFIC CONTRACTOR INFORMATION (continued) Any airless spray guns used? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Any airless spray guns used?”.
SPECIFIC CONTRACTOR INFORMATION (continued) Any epoxies used? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Any epoxies used?”.
SPECIFIC CONTRACTOR INFORMATION (continued) Any lead paint removal done? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Any lead paint removal done?”.
 

Section Name Field Name Field and/or Section Description
Any installation of high pressure Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the
SPECIFIC CONTRACTOR systems, caustics, flammables, question, “Any installation of high pressure systems, caustics, flammables, gases or
INFORMATION (continued) gases or chemicals? chemicals?”.
SPECIFIC CONTRACTOR Any refrigeration systems Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the
INFORMATION (continued) installed? question, “Any refrigeration systems installed?”.
SPECIFIC CONTRACTOR Any mechanical contracting Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the
INFORMATION (continued) operations? question, “Any mechanical contracting operations?”.
Are proper written procedures in
SPECIFIC CONTRACTOR place with respect to “sweating” of Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the
INFORMATION (continued) pipes? question, “Are proper written procedures in place with respect to “sweating” of pipes?”.
SPECIFIC CONTRACTOR Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the
INFORMATION (continued) Any septic tank installation? question, “Any septic tank installation?”.
SPECIFIC CONTRACTOR Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the
INFORMATION (continued) Any asbestos removal done? question, “Any asbestos removal done?”.
SPECIFIC CONTRACTOR Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the
INFORMATION (continued) Any work above two stories? question, “Any work above two stories?”.
SPECIFIC CONTRACTOR
INFORMATION (continued) Commercial % Enter percentage: The percentage of roofing work that is done commercial buildings.
SPECIFIC CONTRACTOR
INFORMATION (continued) Residential % Enter percentage: The percentage of roofing work that is done on residential buildings.
SPECIFIC CONTRACTOR Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the
INFORMATION (continued) Is hot tar used? question, “Is hot tar used?”.
Section Name Field Name Field and/or Section Description
SPECIFIC CONTRACTOR INFORMATION (continued) Are written procedures in place to assure that an opening in the roof will never left unattended and will be properly covered an anchored before leaving the jobsite? Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, “Are written procedures in place to assure that an opening in the roof will never left unattended and will be properly covered an anchored before leaving the jobsite?”.
SPECIFIC CONTRACTOR INFORMATION (continued) Remarks Enter text: The contractors underwriting general remarks. Enter any additional information required for underwriting or rating. Attach ACORD 101, Additional Remarks Schedule, if more space is required.
Edition Date The edition identifier of the form including the form number and edition (the date is typically formatted YYYY/MM).