Quick Renewal Checklist

QUICK RENEWAL CHECKLIST

The FAX Of Life According To Your Insurance Agent

To:

From:

Date:

That line from the popular movie 'Network' may best describe how many clients feel about insurance these days!

Take the confusing, frustrating, and often expensive matter of what's covered and what's not. We go to great lengths to look at your renewal policy each and every year - to make sure that we've done our very best to update your file before you have a loss.

To help save time in this regard, here's a quick checklist to complete and Fax back to us. Once we have this information, we'll be giving you a call to discuss any changes. This way we will have taken one simple step toward lowering anxiety levels in the coming months!

Thanks so much for your cooperation.

Account______________________ Date__________________________

Have you made any major capital expenditures during the year?

YES_______ NO_________

Have you paid or disposed of any major capital asset during the past year?

YES_______ NO_________

Have you purchased, leased, or acquired any real property or locations (including vacant land) during the past year?

YES_______ NO_________

Have you upgraded your procedural or premises security system (by installing an alarm, etc.) during the past year?

YES_______ NO_________

Has your company engaged in any new activities, new products, or new operations during the past year?

YES_______ NO_________

Have you entered any joint ventures, new corporations, or partnerships in the past year?

YES_______ NO_________

Has the financial control, share structure, or gross sales changed substantially during the past year?

YES_______ NO_________

Have there been any unreported legal actions brought against you during the past year?

YES_______ NO_________

Are any employees of your company not covered by Workers Compensation coverage?

YES_______ NO_________

Did you sponsor any teams or conduct any unusual promotional activities during the past year?

YES_______ NO_________

Have there been any changes in your operation during the past year which, in your opinion, may expose you to potential loss?

YES_______ NO_________

The information provided here is accurate and complete to the best of my knowledge as of this date.

_____________________ ______ _____________________ ________

Insured's Signature Date Agent's Signature Date