Renewal Checklist Name First Last Date MM slash DD slash YYYY Client Private Manager(Required)Select OneTracy GilboyVanessa KigerHome InsuranceHave you acquired a second home or any other real estate, such as a cabin, farm property, or any income producing property including short-term and long-term rentals?(Required) Yes No Is your name on a title to any other property we have not previously discussed?(Required) Yes No Do you have any personally owned Trusts or LLC’s on your homes or personal property?(Required) Yes No Have you or are you planning to buy, sell, renovate, remodel, rent out, or add any home additions to your home in the next year?(Required) Yes No Have you refinanced or changed mortgage companies over the past year?(Required) Yes No Would you consider increasing your deductibles to lower your premium?(Required) Yes No Have you acquired or sold any jewelry, fine art, wine collections, silverware, antiques, furs, camera equipment, golf equipment, guns or firearms, coin or stamp collections, or other valuable items or collections, such as unique dishes, figurines, etc?(Required) Yes No Have you installed a central station burglar, fire alarm or smart home technology in your home?(Required) Yes No Do you serve on any Boards of Directors (for profit or nonprofit) or do volunteer work on non‐profit committees?(Required) Yes No Do you conduct any business, give private lessons or engage in any activity from your home that generates revenue?(Required) Yes No Do you have any employees in home such as maid, gardener, nanny or cook?(Required) Yes No Do you engage in any form of farming or ranching?(Required) Yes No Auto InsuranceHave you acquired, or do you rent, any of the following: e-Bikes, boats, motorbikes, motorhomes, 4‐wheelers, snowmobiles, golf carts or other recreational vehicles? (If answer is yes, please put details in open box at bottom)(Required) Yes No Do you own any minibikes, mopeds or motorcycles that we do not insure?(Required) Yes No Are any of your vehicles used for Uber, Lyft, Taxi or Delivery?(Required) Yes No Do we insure all vehicles in your household?(Required) Yes No Are all the licensed drivers in your household listed on your automobile policy?(Required) Yes No Do you have any vehicles furnished for your regular use that you do not own, such as a company car?(Required) Yes No Do you ever drive a vehicle other than the ones we insure for you?(Required) Yes No Do any of your vehicles have customized equipment?(Required) Yes No Additional CoveragesWould you like to add or increase Umbrella or excess liability coverage?(Required) Yes No Would you be interested in adding primary flood insurance to your homeowner's protection?(Required) Yes No Would you be interested in adding excess flood insurance to your homeowner's protection?(Required) Yes No Would you be interested in adding earthquake coverage to your homeowner's protection?(Required) Yes No Would you be interested in purchasing additional mold coverage?(Required) Yes No Is your home located in an area governed by a Homeowner’s or Condominium Association?(Required) Yes No Would you be interested in discussing additional home coverages such as Identity Theft, Cyber, Water Backup, Valuable Articles, Equipment Breakdown, Underground Service Line or Travel Insurance?(Required) Yes No Can we help you with any life insurance or long-term care insurance needs?(Required) Yes No Are you satisfied with our services? (please add any comments to the open dialogue box at bottom)(Required) Yes No Would you be willing to submit a positive review about our service?(Required) Yes No Anything else you would like us to know?
