The SPPA Application Request

Select a SPPA Package

Your company structure:

Example : Partnership, Sole Proprietor, LLC, Corporation.....

Date which you'd like your membership and coverage to be effective:

* (We cannot backdate.)

First and Last Name of Primary Member:

List full names of additional employee(s) to be scheduled on your policy:

Please separate names with commas.

Company name:

Address

City

State

Zip

Cell Phone Number

Office Phone Number

Email Address

Website

Great! Thanks for telling us about yourself. Now let's learn a little more about your business.

About how many accounts do you regularly service or repair?

About how many years experience do you have?

Contractor's license number (if you have one):

Do you subcontract any work to subcontractors?

Yes

No

If you do subcontract, about what percentage of work is subcontracted?

Please let us know with a simple % value.

What are your last years' estimated gross receipts?

A dollar amount is fine.

Service vs Repair

Between service and repair, what type of work are you usually doing?

Pool/Spa vs Fountain vs Pond

Between pool/spa, fountain, and pond, what type of work are you usually doing?

Awesome! Final stretch! Let's talk about your insurance situation.

In the last 5 years, have you had any claims, or do you know of any circumstances that may arise from a claim?

Please list your current or previous insurance carrier or association:

... and how many years with that provider?

If none, simply leave blank.

Finally, what is the primary reason for you seeking a new provider?

If none, simply leave blank.

How did you hear about The SPPA?

Google Search

Social Media

Tradeshow

Word of Mouth

Newsletter

Podcast

Distribution Center

Pool Professional

Other (please tell us below)

Tell us here!