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Business Insurance Renewal Review
Named Insured or Legal Business Name
Name of Person Completing Questionnaire & Title at Company
Email Address
1. Is the Named Insured shown on your Policy(ies) Correct?
Yes
No
N/A
1.b If "No", what should be changed?
2. Have there been any changes in operations, exposures, products, services, new joint ventures/partnerships or equipment in the past year?
3. Do you conduct business online (sell, buy, take payments, etc.)
4. How much was your payroll last year?
4.b How much do you estimate payroll will be this year?
5. Do you have any employees who are working or living in other states that your business resides?
6. Do you believe the current Business Property insurance limits are sufficient (inventory, technology, machinery, etc)?
Yes
No
7. Do you own the building(s) listed on the policy?
Yes
No
7.b If yes, are they owned by the business or in your personal name?
Business Name
Personal Name
7.c If no, what is the name of the owner(s)?
8. Have you purchased, acquired, leased, sold, or replaced any property (especially equipment or vehicles) in the past year?
Yes
No
8.b If Yes, Provide details (when the property was added/removed, what it is worth, identifying numbers, etc.):
9. Have you made any improvements or changes to your existing location(s)?
Yes
No
9.b If yes, please explain and provide estimates if possible:
10. If you are a tenant, have you made any improvements to the building(s) you lease?
Yes
No
10.b If yes, what its the value of the improvements?
11. Do you need coverage for Loss of Income and/or Continuing Expenses should your business be temporarily closed due to a covered loss, such as a fire or theft?
Yes
No
12. Is any insured building vacant or unoccupied?
Yes
No
13. Have there been any changes to Loss Payees/Lienholders?
14. Do you own or use property at any location not listed in your policy?
15. Do you store any personal property for your customers?
Yes
No
16. Do you store any of your business' property on other/unowned locations (ex. temp job sites)?
Yes
No
17. What are your estimated sales for the next year?
18. Would you like to discuss coverage for any of the following?
Mold/Fungi
Terrorism
Boiler, Machinery, or Equipment
Flood
Sewer/Water Backup
19. Are you interested in higher liability limits on your primary (General Liability, Auto, etc.) or Excess Liability policies (Umbrella)?
20. Do you have any employees?
Full-time
Part-time
21. Do you use any sub-contractors?
Yes
No
22. Do you want to discuss protection for employee allegations of discrimination, harassment, etc?
Yes
No
23. Do you sell, distribute or serve alcohol?
Yes
No
23.b If yes, what percentage of your sales is for alcohol?
24. Are your business autos titled in a name other than the business name on your auto policy?
25. Do you or your employees use personal vehicles in the business (including running errands, picking up mail, etc.)?
26. Do you lease or rent autos for your business?
Yes
No
27. Do you want coverage for the administration of employee life / health plans, pension programs, etc.?
28. Have any legal actions, unreported to us or to an insurance carrier, been brought against you?
29. Would you like to discuss coverage for any of the following? Please check all that apply:
Cyber Liability
Professional Liability / Errors & Omissions
Employee Benefits (Health, Life, Vision, Dental, etc)
Employment Practices Liability
Commercial Auto
Workers Compensation
Commercial Umbrella (Excess Liability)
Are there any other questions or concerns we can address for you?
Submit