Homeowners, Condo, and Renters exposures.

1. Do you have collectibles such as antiques, fine arts, stamps, coins, baseball cards or other collectibles?
Your policy has limitations on items that are valuable because of their rarity or provenance.
Yes | No | Not Sure
if Yes please provide details

2. Do you own valuable jewelry or furs?
These items may only be covered up to $1500 ($5000 on some policies) and this does not include all perils such as disappearance and breakage.
Yes | No | Not Sure
if Yes please provide details

3. Do you own firearms or silverware?
These items are limited in coverage, $10,000 for silverware and up to $10,000 for firearms.
Yes | No | Not Sure
if Yes please provide details

4. Do you engage in any farming activity including ownership of animals such as cows or horses?
There are significant limitations with regards to personal property used in farming ($2500), outbuildings used in farming (no coverage), and liability arising out of farming (no coverage).
Yes | No | Not Sure
if Yes please provide details

5. Do you have an alarm in your home? What type Burglar, Fire? Local or Central Station?
An alarm system can save you money on your insurance.
Yes | No | Not Sure
if Yes please provide details

6. Do you have children away at school?
As long as the child is still considered a resident of your household and is 23 years old or under, your homeowners coverage will extend coverage while away at school and enrolled full time.
Yes | No | Not Sure
if Yes please provide details

7. Do you own tools or equipment used in any trade, profession, or business, full or part time?
Property used in any business is limited to $2500 on your premises and $250 away from premises.
Yes | No | Not Sure
if Yes please provide details

8. Do you have an office or studio on your residence premise? Do clients come to your home to make purchases? Do you sell things away from your home?
Liability coverage is limited for business activities, but can be endorsed on in many cases.
Yes | No | Not Sure
if Yes please provide details

9. Have you recently or do you plan to remodel or add onto your home?
Contact us to make sure your home insurance value is up to date.
Yes | No | Not Sure
if Yes please provide details

10.Do you have any outbuilding on your property?
Your policy includes 10% of your homes value (20% on some policies) automatically for outbuildings. Outbuildings used in any business may not be covered.
Yes | No | Not Sure
if Yes please provide details

11. Do you own rental, investment, or vacation property?
Make sure you have adequate property and liability coverage.
Yes | No | Not Sure
if Yes please provide details

Automobile Exposures

12. Does your auto policy cover all of the vehicles in your household, including company cars?
Your auto policy only covers vehicles listed and certain other temporary substitutes and replacement vehicles.
Yes | No | Not Sure
if No please provide details

13. Do you own a car, truck or van with any customization or non-factory installed accessories?
You auto policy may not cover these items
Yes | No | Not Sure
if Yes please provide details

14. Do you own any of the following? If yes, which items?
Yes | No

Boat
Golf Cart
Camper
Moped or Motorcycle ATV
Jet Ski or Personal Watercraft
Snowmobile
Motor home
Tractor
Other Motorized Recreational Vehicle

There are significant limitations for both liability and property regarding these items.

Other Exposures

15. Do you own a business?
Yes | No
if Yes please provide details

16. Did you know that we offer- Long Term Care, Medicare Supplements, Health Insurance, Life and Disability Insurance? We are a full service local agency that can handle most any need.
Yes | No
If Yes, can we provide more information on a Life or Health Coverage? please provide details

17. Do you have a Personal Umbrella Policy? A Personal Umbrella Policy provides additional liability limits (in increments of 1 million) over your Homeowner and Auto Liability Coverages.
Yes | No
If No would you like a proposal on an Umbrella Policy.

Other questions or concerns:

Completed by:

Date:

Best method to Contact: Email | Phone

This questionnaire is intended to help you identify common property or liability exposures that may be limited or not covered by standard insurance policies. This checklist does not supersede any insurance contract nor is it a substitute for a review of your policies for actual terms and conditions of coverage. If in doubt please contact us with your concern.