1. Please identify the following processes and materials utilized in the manufacturing of the Insured’s product:

a. Electroplating or Dip Tanks Yes No

b. Spray Painting Yes No

c. UL Approved Spray Booth Yes No

d. Explosion-Proof Lighting Yes No

e. Welding and Cutting Yes No

If Yes, describe the type of welding and controls in place. ________________________________________________

_____________________________________________________________________________________________________

_____________________________________________________________________________________________________

f. Woodworking Yes No

If Yes, Is there a Dust collection/removal system in place? Describe Controls. _______________________________

_____________________________________________________________________________________________________

2. Describe the Insured’s product

_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

3. Is the final product manufactured for the following industries?

a. Aircraft Yes No

b. Automotive Yes No

c. Chemical Yes No

d. Medical Yes No

e. Pharmaceutical Yes No

f. Powder Coating Yes No

g. Protective Sports Equipment Yes No

h. Railroad Yes No

i. Toy Yes No

j. Watercraft Yes No

4. Are exotic metals used such as titanium, beryllium, magnesium, bismuth, cadmium,

tungsten, lithium, or zirconium? Yes No

5. Have any products been recalled or discontinued? Yes No

If Yes, please explain: _____________________________________________________________________________________

_________________________________________________________________________________________________________

P O I N T O F S A L E Q U E S T I O N N A I R E

BOP Manufacturing

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113-1108 (7/14)

hanover.com

The Hanover Insurance Company | 440 Lincoln Street, Worcester, MA 01653

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6. For Bottled Water, Candy, Chocolate & Confectionary Mfg: Is the Insured involved

in the distribution/sale of nutritional or body- enhancing supplements, energy drinks

or other nutraceuticals? Yes No

7. If the Insured is involved in Metal Work, is there:

a. Any work done on staircases? Yes No

b. Any structural work? Yes No

8. If the Insured is involved in machine shop work, are the jobs done per customer

specifications with customer sign-off? Yes No