Renewal Checklist

Your Name (required)

Your Email (required)

Your Primary Phone Number

Preferred method of contact

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

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?

Please Describe:

Have you added a permanent swimming pool?

Are you interested in earthquake coverage?

Additional Comments:

Every policy has sub-limits. Do you have 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?

Additional Comments:

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

Additional Comments:

Do you own a vacation home that needs insurance?

Please Describe:

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 the same as a mortgagee).

What is the name of the trust?

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

Additional Comments:

Do you own a dog?

What breed?

Do you have a wood burning stove?

Please Describe:

Automobile Insurance

Would you like to review your current liability limits and options to increase them?

Additional Comments:

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

Additional Comments:

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

Additional Comments:

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

Please Describe:

Does our agency insure all of the vehicles you own?

Please Describe:

Do you want to discuss additional coverage(s) available, such as Lease Gap, Towing, or Rental?

Additional Comments:

Would you like us to send you an Insurance ID Card for each of your vehicles?

Do you or anyone in your family use your vehicle for Uber, Lyft, or other delivery service (food, newspapers, pizza, etc)?

Please Describe:

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

Please Describe:

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

Please Describe:

Do you own any of the following that are NOT insured? (Check all that apply):

Please Describe:

Would you like your agent to contact you regarding any questions/concerns regarding any of your insurance policies?

Additional Questions, Comments, or Concerns.