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Commercial Account Review
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(703) 986-0468
Commercial Account Review
Recent life changes can open up your eligibility for discounts or leave you inadequately covered. We can help you keep your insurance coverage up-to-date by conducting an insurance review. Please answer all questions. Thank you for your time!
Client
Policy #
Email
Business Phone
Cell
Change in business entity - e.g., from sole proprietor to a partnership, corporation, LLC or created a new company?
Yes
No
Change in operations/services offered?
Yes
No
Purchase, lease, new construction or alteration of buildings at existing or new locations?
Yes
No
Increase in your business personal property or personal property of others?
Yes
No
Change in payrolls or sales?
Yes
No
Current Payrolls
Current Sales
Change in the amount of use of subcontractors?
Yes
No
Current subcontractor cost:
Business Income/Extra Expense limit adequate?
Yes
No
Current Limit
Off Premises Utility Service Income/Extra Exp limit adequate?
Yes
No
List what we don't currently insure.
Additional vehicles purchased or leased?
Yes
No
Additional drivers of insured vehicles?
Yes
No
Do we insure all lines of business? Package (prop./liab.), work comp, business auto, bcl, business life insurance?
Yes
No
Current Limit
Lifeworks offer made
Yes
No
Optional Coverage
Would you like to discuss adding Employment Practices Liability?
Yes
No
Would you like to discuss adding Data Breach?
Yes
No
Would you like to discuss adding Contractors E & O?
Yes
No
Would you like to discuss adding Mechanical & Electrical Breakdown?
Yes
No
Would you like to discuss adding Enhancement Endorsement?
Yes
No
Would you like to discuss adding Building Ordinance & Law?
Yes
No
Today's Date
*
MM slash DD slash YYYY
Signature
*
Phone
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