Carter & Company - Insurance Managers

Carter & Copany, LLP -- Insurance Managers

Carter & Company - Insurance Managers
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Commercial Insurance Quote

Oil & Gas Consultants Insurance

For the fastest and most accurate oil & gas consultants insurance quote, please provide as much information possible in the form below. This information will be kept confidential and will be used for quote purposes ONLY!

If not in Texas, please click here to view a list of states in which we currently have non-resident licenses.
If your state is not listed then we would not currently have a market for you.

General Information
1. Named Insured:
Contact Name:
2. Address:
3. City: State:   Zip:
4. Phone Number:   Fax Number:
5. Email Address: (Required)
6. Date Firm Established:
7. Applicant is: Individual   Partnership   Joint Venture &#!60; Corporation
8. Does firm have: Other subsidiaries?   A parent company?
Other related entities?
If yes, please explain:
9. Is there an interchange of employees between companies?: Yes   No
If yes, please describe:
10. List all active "key personnel" including titles and designations:
11. Projected Total Gross Payroll:
Gross Manufacturers & Contractors Payroll:
Payroll on land: %
Payroll over water: % (including marshes, bays, inland waters and offshore)
12. Gross Payroll last 12 months:
13. a. Projected Total Revenues:   % Land   % Over Water
b. Actual Receipts For Past 3 Years: 20   $
20   $
20   $
14. Check any operation or service you currently or,
in the future, may perform:
Standard vertical oil or gas drilling or well completion consulting
      services.
Directional/Horizontal oil or gas drilling or well completion services
      as percentages of receipts: %
Oil or Gas lease production or well site consulting, inspection,
      testing or analysis.
Oil or Gas environmental or pollutant cleanup, testing or other
      related services.
Oil or Gas services involving any of the following:
            Re-entry Tools
            Mud
            Chemicals
            Blowout Preventors
            Equipment Sales
            Fishing Tools
            Safety Analysis or loss control service of any kind
            Specialty in-hole well services
            Refineries or Plants
            Equipment Rental
15. Name any professional designations you or your employees have:
16. Do you, your employees, or hired subcontractors do any of the following:
Supervise, manage or control any operations according to verbal or written agreement?: Yes No
 
Supervise, manage or control any any sub-contractor or employees of others?: Yes No
 
Provide written records, analysis, reports, or documentation regarding your operations and/or services to other parties whether or not required by contract written agreement?: Yes No
 
Have any authority or responsibility to anyone regarding any decision making as respects any work or operations performed by you, performed on your behalf or performed by anyone else?: Yes No
17. Number of actual employees other than yourself:
18. Does applicant manage, supervise or direct the work of others?: Yes   No
19. If yes, provide details on the type of work supervised or managed:
20. If no, provide detail on the type of work performed by applicant:
21. Describe 3 major jobs by the applicant in the last year:
22. % of work in: Petro/Chem Plants   Oilfield   Industrial Plants
Over Water   Environmental
23. Please check below what best described your services:
As a consultant, I contract with well operators or owners for gathering, researching or analyzing information which may include observing various operations or reviewing reports for recommendations to be made that relate to oil and gas production or exploration. I cannot oversee, instruct, direct, supervise nor have any involvement in any work or operations that occur or may occur at any site. (IF YOU CHECK THE ABOVE YOU AGREE TO THE FOLLOWING STATEMENT AS A MATERIAL REPRESENTATION FOR ANY COVERAGE TO BE EFFECTED.)
    "As the named insured, the policy coverage terms and conditions and the coverage classification(s) that I request have been fully explained to me by my agent. I completely understand and comprehend that I have no coverage under policy issued if it might be construed, assumed, or deemed by any party that I have any authority, whether implied or not, relating to any operations, work, services, including decisions or judgments made or not made and that might involve or relate to any of my activities covered by the policy."

As a consultant, I contract with well operators or owners to oversee, instruct, direct, supervise or assist them in work or operations at well or lease sites where oil and gas production or exploration is done. I have authorization obtained from well operators or owners to use my judgment relating to work or activities at the various sites which may include hiring subcontractors and advising personnel regarding their work or activities. I may amend or restrict operations based on my judgment in order to complete any work or site activities. I may have the responsibility to report work progress or lack of progress to well operators or owners.

Subcontractors
24. Do you hire subcontractors to work for your firm that you pay?: Yes   No
25. If so, do you have subcontractor sign your Master Service Agreement and furnish proof that they carry insurance equal to yours?: Yes No
26. What jobs do your subcontractors perform?:
27. Are you responsible for hiring subcontractors on behalf of the operator - not counting subcontractors the operator has previously identified to be called in by you to work the job?: Yes No
28. Do you have a formal safety program?: Yes   No
29. Provide the following details on the General Liability coverage for the last 3 years:
  Company Limits Ded/Sir Policy Period Premium
1.
2.
3.
30. Provide a five year General Liability loss and expense history (include any claim, suit, or notice that may give rise to a loss):
DOL Description of Occurrence or Claim Amount Paid Amount Reserve Status
31. Identify over water exposure (if any): Click if: None
USL&H Payroll (Gross): Expected: $   Expiring: $
JONES ACT Payroll (Gross): Expected: $   Expiring: $
Number of Men Exposed: Any One Time:   Any One Place:
Number of Men Exposed Annually?:
Number of Marsh, Bay, and/or Inland Water Jobs During the Past 12 months: %
Fixed Platform: %   Other: %
Number of offshore jobs during the past 12 months: %
Fixed Platform: %   Other:%
Does the insured own, lease, and/or operate watercraft?: Yes   No
If yes, number:   Description:
32. General Liability Insurance Limit Requested: $,000,000/Occurrence,   $,000,000/Aggregate
33. Excess Liability Insurance Limit Requested: $,000,000/Occurrence,    $,000,000/Aggregate
34. Professional Liability Insurance Limit Requested: $,000,000/Occurrence,   $,000,000/Aggregate
35. Please list name and address of at least one certificate holder:
Does certificate holder need to be named as Additional Insured?: Yes   No
Does certificate holder require Waiver of Subrogation?: Yes   No
Does certificate holder require any other special treatment?: Yes   No

Please click on the "Submit Quote" button to send your quote request.
One of our representatives will respond to your submission as soon as possible.

   

 

Important Note: This web site provides only a simplified description of coverages and is not a statement of contract. Coverage may not apply in all states. For complete details of coverages, conditions, limits and losses not covered, be sure to read the policy, including all endorsements, or prospectus, if applicable. Coverage CANNOT be bound, amended, or altered by leaving a message on, or relying upon, information in this Website or through E-MAIL.
         Carter & Company - Insurance Managers
522 E. Crockett, Luling, Texas 78648    Address:
522 E. Crockett
Luling, TX 78648
(Across from Post Office)
Carter & Company - Insurance Managers
P.O. Drawer 672, Luling, Texas 78648-0672    Mailing Address:
P.O. Drawer 672
Luling, Texas 78648-0672
Carter & Company - Insurance Managers
Phone: (830)875-3164 - Toll Free: (800)967-0972 - Fax: (830)875-9362    Phone:
Toll Free:
Fax:
   (830)875-3164
(800)967-0972
(830)875-9362
Carter & Company - Insurance Managers
Hours: Monday - Friday -- 7:30 am - 5:00 pm    Office Hours:
Monday thru Friday
7:30 a.m. - 5:00 p.m.
 
Carter & Company - Insurance Managers
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Carter & Company - Insurance Managers
Carter & Company - Insurance Managers