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Uninsured Contractor Waiver Form Template

Streamline liability management for your contracting projects.

Hiring uninsured contractors can expose you to significant risks and potential losses. This Uninsured Contractor Waiver Form Template is crafted for contractors and homeowners who want to ensure legal protection and limit liability during construction projects. With this template, you can efficiently manage risks, safeguard your business interests, and establish clear expectations with your contractors, all while benefiting from a user-friendly design that aligns with compliance requirements. Explore the live template to start protecting your projects today.

Hiring party legal business name
Authorized representative full name
Contact email for notices
Contractor full legal name
Business or DBA name (if applicable)
Contractor email
Scope of work to be performed
Work location address
Expected start date
Expected end date
Do you currently carry workers compensation insurance for this work?
Yes
No
Do you currently carry general liability insurance for this work?
Yes
No
I acknowledge that I am performing this work without workers compensation and/or general liability insurance.
Strongly disagree
Disagree
Neither
Agree
Strongly agree
I assume all risks of injury or loss arising from my work, to the extent permitted by law.
Strongly disagree
Disagree
Neither
Agree
Strongly agree
I release the hiring party from liability for claims arising from my work, except where prohibited by law.
Strongly disagree
Disagree
Neither
Agree
Strongly agree
I will indemnify and hold harmless the hiring party from claims arising from my acts or omissions, to the extent permitted by law.
Strongly disagree
Disagree
Neither
Agree
Strongly agree
I am an independent contractor and not an employee or agent of the hiring party.
Strongly disagree
Disagree
Neither
Agree
Strongly agree
I am responsible for my own taxes and insurance.
Strongly disagree
Disagree
Neither
Agree
Strongly agree
I will comply with all applicable laws, regulations, and site rules.
Strongly disagree
Disagree
Neither
Agree
Strongly agree
I am financially responsible for my own medical expenses related to any work injury.
Strongly disagree
Disagree
Neither
Agree
Strongly agree
I am authorized to enter into this waiver on behalf of myself or my business.
True
False
Contractor typed signature (enter full legal name)
Hiring party representative typed signature (enter full legal name)
Execution date
{"name":"Hiring party legal business name", "url":"https://www.quiz-maker.com/QPREVIEW","txt":"Hiring party legal business name, Authorized representative full name, Contact email for notices","img":"https://www.quiz-maker.com/3012/images/ogquiz.png"}
paper art illustration depicting an uninsured contractor waiver form with design elements related to contracts and agreements

When to use this form

Use this form when you hire an independent contractor who does not carry general liability or workers' compensation insurance. It fits homeowners, property managers, and small businesses bringing in a handyman, roofer, or painter for short projects. Example: a one-day fence repair, a weekend drywall patch, or hauling debris. The form documents the contractor's acknowledgment of risk, sets safety rules, defines scope and dates, and helps limit your exposure if someone is hurt or property is damaged. For higher-risk tasks, you can pair it with a Personal injury waiver form. If the contractor will drive your vehicle or move materials on site, add a Vehicle damage waiver form.

Must Ask Uninsured Contractor Waiver Questions

  1. What is your legal name, business entity type, and contact information?

    This identifies who is assuming risk and who can lawfully sign. Clear contact details make follow-up, notices, and enforcement straightforward.

  2. What is the project location and detailed scope of work, including start and end dates?

    Defining where and what work occurs limits the waiver to the intended job. Dates prevent accidental coverage of future or unrelated tasks.

  3. Do you carry general liability and workers' compensation, and if not, do you acknowledge you are working uninsured?

    A direct acknowledgment creates a clear record of the risk the contractor accepts. It also guides your oversight, payment terms, and site controls.

  4. Will you or your crew operate vehicles or heavy equipment on site, and do you agree to follow site safety and traffic rules?

    This flags higher-risk activities so you can set controls and require proof of competence. If vehicles are involved, you may also use a Vehicle compliance waiver form to address operating requirements.

  5. Do you agree to indemnify and hold harmless the property owner and waive claims arising from your work, and will you sign and date this waiver?

    This clarifies the transfer of risk and reduces disputes if a loss occurs. A signature and date help make the waiver enforceable.

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