Personal Lines Renewal Checklist – Dan Schmidt Name of Person Completing Checklist(Required) First Last Email(Required) Date(Required) MM slash DD slash YYYY Home InsuranceHave you acquired a second home or any other real estate, such as a cabin, farm property, or any income producing property?(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 do any home additions, renovations or remodeling?(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, firearms, or other valuable items or collections?(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 Auto InsuranceHave you acquired any of the following: e-Bikes, boat, motorbike, motorhome, 4‐wheeler, snowmobile, golf cart 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 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 discussing or adding earthquake or flood coverage to your policy?(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 needs?(Required) Yes No Anything else you would like us to know?