How do you want the client's name to appear in this proposal?
Enter the full name of the producer you would like to show on the cover page. (Include designations)
Enter the producer's title for the cover page.
What is the producer's email address? *
Upload your company logo to have it appear on each page of this proposal.
Select the color theme you would like to use in this proposal.
Enter the agency address you would like on the cover page.
Please enter a disclaimer and/or carrier rating.
Click the box below if you want to use this disclaimer/carrier rating on all pages of this proposal?
Customize your proposal by selecting the pages you would like to include in this document.
Home Location 1
Enter a title for the Home Location 1 page of this proposal.
Enter: Proposed Carrier Name for Home Location 1
Click the box below if you want to use the carrier name entered above on all proposal pages.
Enter: Home location 1 address.
Enter a description for Coverage A. (Ie. Dwelling/Additions & Alterations)
Enter: Proposed Carrier Dwelling/Additions & Alterations Limit.
Enter a description for other structures. (Ie. Other Structures)
Enter: Proposed Carrier Other Structures Limit
Enter a description for personal property/blanket limit. (Ie. Personal Property or Blanket Limit)
Enter: Proposed Carrier Personal Property/Blanket Limit.
Enter a description for loss of use. (Ie. Loss of Use or Alternative Living Expenses)
Enter: Proposed Carrier Loss of Use Limit
Enter a description for personal liability. (Ie. Personal Liability)
Enter: Proposed Carrier Personal Liability Limit
Enter a description for medical payments. (Ie. Medical Payments)
Enter: Proposed Carrier Medical Payments Limit
Enter: All Other Perils Deductible Description.
Enter: A title for the first deductible option. (I.e. Option 1)
Enter: A title for the second deductible option. (I.e. Option 2)
Enter: All Other Perils Deductible for the First Deductible Option.
Enter: All Other Perils Second Deductible Option Amount.
Enter: Second Deductible Type Description.
Enter: Second Deductible Type and First Deductible Option Amount.
Enter: Second Deductible Type and Second Deductible Option Amount.
Enter: Third Deductible Type Description.
Enter: Third Deductible Type and First Deductible Option Amount.
Enter: Third Deductible Type and Second Deductible Option Amount.
Enter: Annual Premium for the First Deductible Option.
Enter: Annual Premium for the Second Deductible Option.
Enter: A title for the additional coverage options section. (I.e. Additional Coverage Options)
Enter: First Optional Coverage Description.
Enter: First Optional Coverage Limit.
Enter: First Optional Coverage Deductible.
Enter: First Optional Coverage Premium.
Enter: Second Optional Coverage Description.
Enter: Second Optional Coverage Limit.
Enter: Second Optional Coverage Deductible.
Enter: Second Optional Coverage Premium.
Enter: Third Optional Coverage Description.
Enter: Third Optional Coverage Limit.
Enter: Third Optional Coverage Deductible.
Enter: Third Optional Coverage Premium.
Enter: Fourth Optional Coverage Description.
Enter: Fourth Optional Coverage Limit.
Enter: Fourth Optional Coverage Deductible.
Enter: Fourth Optional Coverage Premium.
Enter: Fifth Optional Coverage Description.
Enter: Fifth Optional Coverage Limit.
Enter: Fifth Optional Coverage Deductible.
Enter: Fifth Optional Coverage Premium.
Please enter notes about this homeowners policy below.
Please enter a disclaimer and/or carrier rating.
Home Location 1 Profile
Enter a title for the Home Profile 1 page of this proposal.
Enter: Proposed Carrier Name for Home Location 1
Click the box below to copy the address from the Home Location 1 page to the Home Profile 1 page.
Enter: Home location 1 address.
Central Station Burglar Alarm?
Central Station Fire Alarm?
Guard Gated Community?
Low Temperature Monitoring?
Permanently Installed Generator?
Water Leak Detection with Master Valve Shutoff?
24 Hour Signal Continuity?
Lightning Protection?
Gas Leak Detector?
External Perimeter Gate?
External Perimeter Security Protection?
Full Time Live-in Caretaker?
Lien/Mortgage Free?
Residential Sprinkler System?
Sprinkler System with Water Flow Alarm?
Auto Companion?
Excess Liability Companion?
Valuable Articles Companion?
Year Built?
Year Renovated?
Beachfront (<500 ft to salt water)?
Construction Type?
LEED Certified?
Flood Zone?
Age of Roof?
Roof Shape?
Size of Home (Heated)?
Protection Class?
Seasonal Home?
Vacant Home?
Rental Home?
Enter home profile notes below.
Please enter a disclaimer and/or carrier rating.
Home Location 2
Enter a title for the Home Location 2 page of this proposal.
Enter: Proposed Carrier Name for Home Location 2
Enter: Home location 2 address.
Click the box below to copy the coverage descriptions, deductible options, and additional coverages from the Home Location 1 page to the Home Location 2 page.
Enter a description for Coverage A. (Ie. Dwelling/Additions & Alterations)
Enter: Proposed Carrier Dwelling/Additions & Alterations Limit.
Enter a description for other structures. (Ie. Other Structures)
Enter: Proposed Carrier Other Structures Limit
Enter a description for personal property/blanket limit. (Ie. Personal Property or Blanket Limit)
Enter: Proposed Carrier Personal Property/Blanket Limit.
Enter a description for loss of use. (Ie. Loss of Use or Alternative Living Expenses)
Enter: Proposed Carrier Loss of Use Limit
Enter a description for personal liability. (Ie. Personal Liability)
Enter: Proposed Carrier Personal Liability Limit
Enter a description for medical payments. (Ie. Medical Payments)
Enter: Proposed Carrier Medical Payments Limit
Enter: All Other Perils Deductible Description.
Enter: A title for the first deductible option. (I.e. Option 1)
Enter: A title for the second deductible option. (I.e. Option 2)
Enter: All Other Perils Deductible for the First Deductible Option.
Enter: All Other Perils Second Deductible Option Amount.
Enter: Second Deductible Type Description.
Enter: Second Deductible Type and First Deductible Option Amount.
Enter: Second Deductible Type and Second Deductible Option Amount.
Enter: Third Deductible Type Description.
Enter: Third Deductible Type and First Deductible Option Amount.
Enter: Third Deductible Type and Second Deductible Option Amount.
Enter: Annual Premium for the First Deductible Option.
Enter: Annual Premium for the Second Deductible Option.
Enter: A title for the additional coverage options section. (I.e. Additional Coverage Options)
Enter: First Optional Coverage Description.
Enter: First Optional Coverage Limit.
Enter: First Optional Coverage Deductible.
Enter: First Optional Coverage Premium.
Enter: Second Optional Coverage Description.
Enter: Second Optional Coverage Limit.
Enter: Second Optional Coverage Deductible.
Enter: Second Optional Coverage Premium.
Enter: Third Optional Coverage Description.
Enter: Third Optional Coverage Limit.
Enter: Third Optional Coverage Deductible.
Enter: Third Optional Coverage Premium.
Enter: Fourth Optional Coverage Description.
Enter: Fourth Optional Coverage Limit.
Enter: Fourth Optional Coverage Deductible.
Enter: Fourth Optional Coverage Premium.
Enter: Fifth Optional Coverage Description.
Enter: Fifth Optional Coverage Limit.
Enter: Fifth Optional Coverage Deductible.
Enter: Fifth Optional Coverage Premium.
Please enter notes about this homeowners policy below.
Please enter a disclaimer and/or carrier rating.
Home Location 2 Profile
Enter a title for the Home Profile 2 page of this proposal.
Enter: Proposed Carrier Name for Home Location 2
Click the box below to copy the address from the Home Location 2 page to the Home Profile 2 page.
Enter: Home location 2 address.
Central Station Burglar Alarm?
Central Station Fire Alarm?
Guard Gated Community?
Low Temperature Monitoring?
Permanently Installed Generator?
Water Leak Detection with Master Valve Shutoff?
24 Hour Signal Continuity?
Lightning Protection?
Gas Leak Detector?
External Perimeter Gate?
External Perimeter Security Protection?
Full Time Live-in Caretaker?
Lien/Mortgage Free?
Residential Sprinkler System?
Sprinkler System with Water Flow Alarm?
Auto Companion?
Excess Liability Companion?
Valuable Articles Companion?
Year Built?
Year Renovated?
Beachfront (<500 ft to salt water)?
Construction Type?
LEED Certified?
Flood Zone?
Age of Roof?
Roof Shape?
Size of Home (Heated)?
Protection Class?
Seasonal Home?
Vacant Home?
Rental Home?
Enter home profile notes below.
Please enter a disclaimer and/or carrier rating.
Valuable Articles
Enter a title for the Valuable Articles page of this proposal.
Valuable Articles Proposed Carrier Name?
Scheduled Jewelry Limit?
Blanket Jewelry Limit?
Blanket Jewelry Single Article Limit?
Scheduled & Blanket Jewelry Premium?
Bank Vaulted Scheduled Jewelry Limit?
Bank Vaulted Blanket Jewelry Limit?
Bank Vaulted Blanket Jewelry Single Article Limit?
Bank Vaulted Scheduled Jewelry Premium?
Scheduled Fine Art Limit?
Blanket Fine Art Limit?
Blanket Fine Art Single Article Limit?
Scheduled & Blanket Fine Art Premium?
Scheduled Collectibles Limit?
Blanket Collectibles Limit?
Blanket Collectibles Single Article Limit?
Scheduled & Blanket Collectibles Premium?
Scheduled Stamps/Coins/Furs/Musical Instruments Limit?
Blanket Stamps/Coins/Furs/Musical Instruments Limit?
Blanket Stamps/Coins/Furs/Musical Instruments Single Article Limit?
Scheduled & Blanket Stamps/Coins/Furs/Musical Instruments Premium?
Scheduled Wine Limit?
Blanket Wine Limit?
Blanket Wine Single Article Limit?
Scheduled & Blanket Wine Premium?
Scheduled Firearms Limit?
Blanket Firearms Limit?
Blanket Firearms Single Article Limit?
Scheduled & Blanket Firearms Premium?
Scheduled Miscellaneous Limit?
Blanket Miscellaneous Limit?
Blanket Miscellaneous Single Article Limit?
Scheduled & Blanket Miscellaneous Premium?
Scheduled Other Limit?
Blanket Other Limit?
Blanket Other Single Article Limit?
Scheduled & Blanket Other Premium?
Total Annual Valuable Articles Premium?
Recent Jewelry Appraisals? (Less than two years old)
Recent Fine Art Appraisals? (Less than five years old)
Central Station Fire Alarm?
Central Station Burglar Alarm?
Permanently Installed Home Safe?
Homeowners Companion Policy Credit?
Enter notes for the valuable articles proposal below.
Please enter a disclaimer and/or carrier rating.
Automobile
Enter a title for the Automobile page of this proposal.
Enter: Proposed Carrier Name for the Automobile Policy.
Enter a description for liability coverage. (Ie. Bodily Injury Liability)
Enter: Bodily Injury Liability Limit.
Enter a description for property damage liability coverage. (Ie. Property Damage Liability)
Enter: Property Damage Liability Limit.
Enter a description for uninsured/underinsured motorist coverage. (Ie. Uninsured/Underinsured Motorist)
Enter: Uninsured/Underinsured Motorist Limit.
Enter a description for medical payments coverage. (Ie. Medical Payments or Personal Injury Protection)
Enter: Medical Payments or Personal Injury Protection Limit.
Enter the total annual automobile policy premium.
Enter: A title for the property coverages table. (I.e. Coverages)
Enter a description for policy level coverages. (Ie. Liability Coverages Included)
How would you like to describe the total loss settlement category on this proposal? (Ie. Agreed Value or Market Value)
Enter a description for comprehensive deductibles. (Ie. Comprehensive Deductible)
Enter a description for collision deductibles. (Ie. Collision Deductible)
Enter a description for rental reimbursement. (Ie. Rental Reimbursement, Loss of Use, etc.
Enter a description for roadside assistance. (Ie. Roadside Assistance)
Enter a description for full glass coverage. (Ie. Full Glass)
Enter: Year, make and model of the first vehicle.
Does the first vehicle include liability coverages/policy level coverages?
Enter: First vehicle loss settlement or agreed value.
Enter: First vehicle comprehensive deductible amount.
Enter: First vehicle collision deductible amount.
Enter: First vehicle rental reimbursement or loss of use amount.
Enter: First vehicle roadside assistance or towing amount.
Enter: First vehicle full glass coverage.
Enter: First vehicle annual premium.
Will there be a second vehicle on this proposal?
Enter: Year, make and model of the second vehicle.
Click the box below to copy the coverage descriptions and limits from the first vehicle to the second vehicle.
Does the second vehicle include liability coverages/policy level coverages?
Enter: Second vehicle loss settlement or agreed value.
Enter: Second vehicle comprehensive deductible amount.
Enter: Second vehicle collision deductible amount.
Enter: Second vehicle rental reimbursement or loss of use amount.
Enter: Second vehicle roadside assistance or towing amount.
Enter: Second vehicle full glass coverage.
Enter: Second vehicle annual premium.
Will there be a third vehicle on this proposal?
Enter: Year, make and model of the third vehicle.
Click the box below to copy the coverage descriptions and limits from the first vehicle to the third vehicle.
Does the third vehicle include liability coverages/policy level coverages?
Enter: Third vehicle loss settlement or agreed value.
Enter: Third vehicle comprehensive deductible amount.
Enter: Third vehicle collision deductible amount.
Enter: Third vehicle rental reimbursement or loss of use amount.
Enter: Third vehicle roadside assistance or towing amount.
Enter: Third vehicle full glass coverage.
Enter: Third vehicle annual premium.
Will there be a fourth vehicle on this proposal?
Enter: Year, make and model of the fourth vehicle.
Click the box below to copy the coverage descriptions and limits from the first vehicle to the fourth vehicle.
Does the fourth vehicle include liability coverages/policy level coverages?
Enter: Fourth vehicle loss settlement or agreed value.
Enter: Fourth vehicle comprehensive deductible amount.
Enter: Fourth vehicle collision deductible amount.
Enter: Fourth vehicle rental reimbursement or loss of use amount.
Enter: Fourth vehicle roadside assistance or towing amount.
Enter: Fourth vehicle full glass coverage.
Enter: Fourth vehicle annual premium.
Will there be a fifth vehicle on this proposal?
Enter: Year, make and model of the fifth vehicle.
Click the box below to copy the coverage descriptions and limits from the first vehicle to the fifth vehicle.
Does the fifth vehicle include liability coverages/policy level coverages?
Enter: Fifth vehicle loss settlement or agreed value.
Enter: Fifth vehicle comprehensive deductible amount.
Enter: Fifth vehicle collision deductible amount.
Enter: Fifth vehicle rental reimbursement or loss of use amount.
Enter: Fifth vehicle roadside assistance or towing amount.
Enter: Fifth vehicle full glass coverage.
Enter: Fifth vehicle annual premium.
Enter notes for the automobile proposal below.
Please enter a disclaimer and/or carrier rating.
Watercraft
Enter a title for the Watercraft page of this proposal.
Enter: Proposed Carrier Name for the Watercraft
Enter: Watercraft/Vessel Year, Make, Model and Length.
Enter a description for the hull value coverage. (I.e. (Hull Value or Property Damage)
Enter: Hull value or property damage limit.
Enter a description for personal property coverage. (I.e. Personal Property)
Enter: Personal property limit.
Enter a description for the trailer coverage. I.e. Trailer)
Enter: Trailer limit.
Enter a description for emergency towing and service coverage. (I.e. Emergency Towing & Service)
Enter: Emergency towing and service limit.
Enter a description for tender/dinghy coverage. (I.e. Tender/Dinghy)
Enter: Tender/dinghy limit.
Enter a description for pollution and Indemnity coverage. I.e. Pollution & Indemnity)
Enter: Pollution & Indemnity limit.
Enter a description for uninsured boaters coverage. (I.e. Uninsured Boaters)
Enter: Uninsured Boaters limit.
Enter a description for medical payments coverage. (I.e. Medical Payments)
Enter: Medical payments limit.
Enter: Total annual premium for the watercraft.
Enter a description for the first deductible type for this watercraft. (I.e. Property Damage)
Enter: First deductible type amount.
Enter a description for the second deductible type for this watercraft. (I.e. Windstorm)
Enter: Second deductible type amount.
Enter a description for the third deductible type for this watercraft. (I.e. Trailer)
Enter: Third deductible type amount.
Enter a description for the first additional detail/coverage for this watercraft. (I.e. Navigation Limits)
Enter: Details or coverage amount for the first additional detail/coverage.
Enter a description for the second additional detail/coverage for this watercraft. (I.e.Lay-up Period)
Enter: Details or coverage amount for the second additional detail/coverage.
Enter a description for the third additional detail/coverage for this watercraft. (I.e.Equipment Breakdown)
Enter: Details or coverage amount for the third additional detail/coverage.
Type any notes or remarks regarding this Watercraft proposal below.
Please enter a disclaimer and/or carrier rating.
Umbrella / Excess Liability
Enter a title for the Excess Liability page of this proposal.
Enter: Proposed Carrier Name For The Umbrella
Enter a description for the bodily injury and property damage coverage. (I.e. Bodily Injury and Property Damage)
Enter: Bodily injury and property damage limit.
Enter: Bodily injury and property damage premium.
Enter a description for the excess uninsured/underinsured motorist coverage. (I.e. Excess Uninsured/Underinsured Motorist)
Enter: Excess uninsured/underinsured motorist limit.
Enter: Excess uninsured/underinsured motorist premium.
Enter a description for the uninsured/underinsured coverage. (I.e. Uninsured/Underinsured)
Enter: Uninsured/underinsured limit.
Enter: Uninsured/underinsured premium.
Enter a description for the employers practices liability coverage. (I.e. Employers Practices LIability)
Enter: Employers practices liability limit.
Enter: Employers practices liability premium.
Enter: Total annual excess liability premium.
Click the box below to copy the address for Home Location 1 to the Umbrella/Excess Liability page.
Enter the address of the first covered location.
Does the first covered location have a pool?
What is the usage of the first covered location? (I.e. Primary, Secondary, Rental)
Do you want to add a second location to the Umbrella/Excess Liability page?
Click the box below to copy the address for Home Location 2 to the Umbrella/Excess Liability page.
Enter the address of the second covered location.
Does the second covered location have a pool?
What is the usage of the second covered location? (I.e. Primary, Secondary, Rental)
Do you want to add a third location to the Umbrella/Excess Liability page?
Enter the address of the third covered location.
Does the third covered location have a pool?
What is the usage of the third covered location? (I.e. Primary, Secondary, Rental)
Enter a heading to show above the first exposures section. (I.e. Automobile(s))
How many automobiles are covered by this umbrella?
Enter a heading to show above the second exposures section. (I.e. Watercraft)
How many watercraft are covered by this umbrella?
List the operators covered by this umbrella. (Line 1)
List more operators covered by this umbrella. (Line 2)
Please enter notes and remarks for the umbrella policy below.
Please enter a disclaimer and/or carrier rating.
Premium Summary
Enter the name(s) of the carrier(s) you are proposing.
Click the box below to copy policy descriptions and annual premiums from this proposal into the premium summary table.
Enter a description for home location 1.
Enter: Proposed Carrier Home Location 1 Premium.
Enter a description for home location 2.
Enter: Proposed Carrier Home Location 2 Premium.
Enter a description for the valuable articles.
Enter: Proposed Carrier Valuable Articles Premium.
Enter a description for the automobile policy.
Enter: Proposed Carrier Automobile Premium.
Enter a description for the watercraft policy.
Enter: Proposed Carrier Watercraft Premium.
Enter a description for the personal umbrella/excess liability policy.
Enter: Proposed Carrier Umbrella Premium.
Enter: Total Annual Premium
Please enter any notes you would like to appear on the Premium Summary page.
Please enter a disclaimer and/or carrier rating.
Proposal Preview
Proposal Preview (Note: If a logo was uploaded, it will not show in this preview. It will show on the PDF once the form has been submitted.)
