Renewal Checklist

Your Name (required)

Your Email (required)

Your Phone

Preferred method of contact

What type of insurance do you have with us? Check all that apply.

Homeowners Insurance

Have you renovated, remodeled, added on to, or otherwise updated your home?

Please Describe

Do you do any of the following: Operate an office or studio in your home, babysit in your home, or have clients come into your home to make purchases?

Please Describe:

Do you own tools, equipment, or instruments used in your trade or profession?

Have you added a permanent swimming pool?

Are you interested in earthquake coverage?

Every policy has sub-limits. Do you own any of the following and need a quote to schedule these items to your policy:

Jewelry $:
Antiques $:
Art $:
Guns $:
Other $:

Do you want a quote to add OR increase your current limit of Backup of Sewer and Drains?

Flood may be excluded from your policy. Would you like more information on how to purchase Flood Insurance?

Do you own a vacation home that needs insurance?

Coverage for liability from a Trampoline may be excluded. Do you own a Trampoline and need to discuss this?

Would it cost more to rebuild your home than the amount it is insured for?

Is your home titled in a Trust? (this is NOT that same as a mortgagee).

Do you want a quote to increase your Umbrella Liability Policy OR do you want a quote for an Umbrella Liability Policy?

Do you own a dog?

What breed?

Do you have a wood burning stove?

Do you keep more than $100 cash in your home?

Automobile Insurance

Do you want a quote to increase your auto liability limit?

Does your auto policy specify by name all of the drivers in your household?

Do you have a teen in your household that will obtain a drivers license this year?

Do you have a company car furnished for your regular use?

Does our agency insure all of the vehicles you own?

Do you want to talk about additional coverage available, such as Lease Gap, Towing, or Rental?

Would you like us to send you a FREE Insurance ID Card Holder for each of your vehicles?

Do you or anyone in your family use your vehicle for Uber, Lyft, or delivery?

Is anyone else a titled owner of a vehicle listed on your policy other than your or your spouse?

Do you have any children listed on your auto policy who no longer live at home and are not in college?

Do you own any of the following? (Check all that apply):

Would you like your agent to contact you regarding other insurance questions/concerns?

Additional Questions, Comments, or Concerns.