Renewal Questionnaire

1) Full Name *

2) Street Address

9) Do you have collectibles: antiques, fine art, stamps, coins, etc.? YesNo

10) Do you have valuable jewelry? YesNo

11) Do you have a business in your home? YesNo

12) Do clients or customers come to your home? YesNo

13) Do you own professional tools or equipment? YesNo

14) Do you baby-sit or have child day care in your home? YesNo

15) Do you own rental or income property? YesNo

16) Do you have a secondary residence? YesNo

17) Do you own investment property? YesNo

18) Have you installed home fire or security alarms? YesNo

19) Do you own recreational vehicles: boat, jet-ski, camper, cycle, etc.? YesNo

20) Have you remodeled your home? Have plans to do so? YesNo

21) Do you have "umbrella" liability coverage? YesNo

22) Do you have an above ground or in ground swimming pool? YesNo

23) Do you have detached structures: gazebos, storage barn? YesNo

24) Have there been any recent updates to your Home? YesNo

25) Do you have domestic help, babysitters, landscapers, and house cleaners ? YesNo

26) Do you have a wood burning stove? YesNo

27) Do you have a fireplace? YesNo

28) Have you had your chimney professionally cleaned and inspected within the last 12 months? YesNo

29) Do you have flood insurance? YesNo

30) Is there or has there ever been evidence of water leakage or seeping in the residence?

31) Do you have earthquake insurance? YesNo

32) Would you like to have identity theft protection within your homeowners policy? YesNo

33) Have you recently married? YesNo

34) Have you recently divorced? YesNo

35) Have you recently had or adopted children? YesNo

888.423.9268