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Introduction
As previously mentioned, our top priority is to reduce, transfer, or eliminate your personal exposure by keeping your risk profile up-to-date. Please review the following questions to ensure that we have the most up-to-date information for your personal lines policies.
What is your full name?
What is your email address?
Additional Risks to Consider
Click the check box next to the additional area(s) of risk that you would like to evaluate.
Sharing Economy Risks
Please select the type(s) of sharing economy activities you or a family member participated in as a seller.
Please describe the home sharing activities.
Please describe the car sharing activities.
Please describe the pool sharing activities.
Please describe the backyard sharing activities.
Please describe the equipment sharing activities.
Please describe the boat sharing activities.
Please describe the RV sharing activities.
Please describe the driveway/garage sharing activities.
Please describe the storage space sharing activities.
Please describe the other sharing activities you are engaging in.
Do you currently lend or intend to lend any valuable articles out to a third party?
Emerging Risks
Please provide details of the change in ownership of your home.
Please provide details of the change in occupancy.
Please select the type(s) of emerging risks you or a family member participated in.
Please describe your NFT purchase.
Please describe your eBike purchase.
Please describe your piloting of a drone.
Please provide details on your hiring of domestic employee(s).
Please provide details on the not-for-profit board you volunteer on.
Please describe your travel to risky locations.
Please describe your use of a car for food delivery.
Please describe the other emerging risks you are involved in.
Additional Coverage Options
Do you own additional property or have additional policies we do not currently insure?
Please select the addition property type(s) or polices we do not currently insure.
Please enter the details requested below for the additional property(s) you own.
Please upload the declarations pages for your other insurance policies.
Please enter the details requested below for the automobile(s) we do not insure.
Are any of the automobiles leased or financed?
Please select the lien holder/leasing company. (If the company is not listed or the language is not precise please choose "Other" and enter the details.)
Please enter the lien holder/leasing company name and address.
Please enter the details requested below for the recreational vehicle(s) we do not insure.
Are any of the recreational vehicles leased or financed?
Please select the lien holder/leasing company. (If the company is not listed or the language is not precise please choose "Other" and enter the details.)
Please enter the lien holder/leasing company name and address.
Please enter additional details about the property or policies that we do not insure.
Please select the coverages for which you would like us to provide an insurance proposal.
Disclaimer: This online questionnaire is a tool used to gather information. It is not an application for insurance. No insurance coverage will be bound or put into effect by submitting this form.
Consumer disclosure: By checking the box below you authorize the Agency who supplied this form to you to contact you via phone, email, and text messaging; to save and share with business partners the information you provided; to obtain consumer reports that may include credit-based reports (where legally allowed), public records, claims history, and driving records so that they can give you accurate insurance quotes. *
