Your insurance needs are ever changing. Please review these few simple questions enabling us to keep your policy updated.
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| Address: |
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| Phone Number: |
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| Fax Number: |
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| Email Address: |
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| Is the named insured listed correctly? |
Yes
No
If no, please provide us with the correct information.
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| Are the mailing address, phone and fax numbers, and contact name listed correctly? |
Yes
No
If no, please provide us with the correct information.
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| Have there been any changes in your operations this year? |
Yes
No
If yes, please describe.
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| Please review the list locations on your current policy. Are there any changes? |
Yes
No
If yes, please describe.
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| Please review your building, personal property, computer and equipment coverage limits. Are these limits adequate? |
Yes
No
If no, please provide the correct limits.
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| Have there been any changes in vehicles or drivers? |
Yes
No
If yes, please provide the correct information.
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| Has your employee situation changed within the last year? Any major changes in payroll? Any changes projected for the coming year? |
Yes
No
If yes, please provide the correct information.
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| Are the loss payees and mortgagees listed correctly? |
Yes
No
If no, please provide us with the correct information.
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| Do you have any other insurance needs you would like to discuss? |
Yes
No
Additional Comments:
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