Questionnaire: Business

Company Name*

Your Name*

Email*

I understand that filling out and submitting this form DOES NOT bind coverage.*

BUSINESS QUESTIONNAIRE

Do you wish to make, or do circumstances require any changes to your current liability limits or coverage amounts?

Have you made any improvements or renovations to your buildings or added any structures since you last reviewed the coverage amounts on your policy?

If yes, please give a description:

Does your building/premises have (click all that apply for YES):

Have you added, changed, or deleted any security systems, safes, or sprinkler system?

Any changes or additional equipment, signs, computer equipment, or tools purchased?

Has there been any change in your business; such as (click all that apply for YES):

New products sold or services provided
Changes to existing products or services offered
Changes in operations or types of work performed
Are you regularly in possession of other people’s property? (i.e., for repair or maintenance)
Do you or any employee carry company money off site
Are all owned or leased vehicles listed on your policy
Do you work, maintain or operate a business, or keep samples for your business at any other location not listed on your policy
Does the business own or rent any water craft or aircraft? If yes please describe:

Does the business own any animals such as guard dogs?

If yes, please describe:

Have there been any changes in (click if YES):

If yes, please give description:

Have there been any changes in (click if YES):

If yes, please give description:

Have there been any changes in (click if YES):

If yes, please give description:

Do you own any additional property, vacant land, or rent or sublet any portion of your building to others?

Do you obtain certificates of insurance for all subcontractors?

Your business policy DOES NOT provide flood insurance. Would you be interested in a flood insurance cost quotation?

Would you be interested in a quotation for (click all that apply for YES):

Phone

This field is for validation purposes and should be left unchanged.