BUSINESS INSURANCE RENEWAL FORM:Please fill out the following form and we will get back with you if we have any questions.Please enable JavaScript in your browser to complete this form.Company NameName *FirstLastEmail *PhoneHAS THE NAME OF YOUR BUSINESS CHANGED?HAVE YOU RESTRUCTURED YOUR COMPANY'S OWNERSHIP?(E.G., GONE FROM SOLE PROPRIETORSHIP TO LLC OR CORPORATION) OR ADDED ANY DBAS (DOING BUSINESS AS)?HAS YOUR BUSINESS CHANGED OWNERS, PARTNERS OR OFFICERS?HAS THE NATURE OF YOUR BUSINESS OPERATIONS CHANGED?HAVE YOU CHANGED OR EXPANDED THE TYPES OF PRODUCTS YOU SELL AND/OR SERVICES YOU OFFER?HAVE YOU PURCHASED NEW EQUIPMENT?DO YOU HAVE LEASED/RENTED/BORROWED EQUIPMENT?HAVE YOU ADDED NEW LOCATIONS, EXPANDED INTO NEW STATES OR OUTSIDE OF THE UNITED STATES?HAVE YOU CLOSED OR MOVED ANY LOCATIONS?WHAT ARE YOUR ANNUAL SALES?HAVE YOU HIRED NEW EMPLOYEES?YESNOWHAT ARE YOUR TOTAL NUMBER OF EMPLOYEES?DO YOU HAVE REMOTE WORKERS?YESNOHAS YOUR PAYROLL CHANGED?YESNOPLEASE VERIFY ANNUAL PAYROLL:WHAT PORTION OF ANNUAL PAYROLL IS OWNERS PAYROLL?ARE YOU SPECIFICALLY COVERED FOR HACKS, VIRUSES AND DATA BREACHES?YESNODO YOU HAVE DIGITAL ASSETS?YESNODO YOU HAVE ACCESS TO A THIRD PARTY’S SYSTEM?YESNODO YOU SELL ANYTHING ONLINE?YESNOHAVE YOU ADDED OR ELIMINATED VEHICLES USED IN YOUR BUSINESS OPERATIONS?HOW DO YOU USE YOUR VEHICLES FOR BUSINESS?DO YOU RENT VEHICLES FOR BUSINESS USE?DO YOU USE YOUR PERSONAL VEHICLE FOR BUSINESS?YESNODO YOU ALLOW EMPLOYEES TO USE YOUR PERSONAL VEHICLE FOR BUSINESS?YESNODO YOU ALLOW EMPLOYEES TO USE THEIR OWN PERSONAL VEHICLES FOR YOUR BUSINESS?YESNOWHO DRIVES YOUR BUSINESS VEHICLES?Submit
