Personal Lines Renewal Checklist Name of Person Completing Checklist(Required) First Last Email(Required) Robertson Ryan Agent/ Customer Service Representative(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? No change since last year Yes No Is your name on a title to any other property we have not previously discussed? Yes No Do you have any personally owned Trusts or LLC’s on your homes or personal property? No change since last year Yes No Have you or are you planning to do any home additions, renovations or remodeling? No change since last year Yes No Have you replaced your roof in the last 12 months? Yes No Have you refinanced, paid off or changed mortgage companies over the past year? Yes No Would you consider increasing your deductibles to lower your premium? 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? No change since last year Yes No Have you installed a central station burglar, fire alarm or smart home technology in your home in the last 12 months? Yes No A claim which requires mold remediation could be excluded or limited depending on your policy. Are you interested in discussing this coverage? Yes No Do you serve on any Boards of Directors (for profit or nonprofit) or do volunteer work on non‐profit committees? No change since last year Yes No Do you conduct any business, give private lessons or engage in any activity from your home that generates revenue? No change since last year Yes No Do you have any employees in home such as maid, gardener, nanny or cook? No change since last year Yes No Do you have a dock on your premises? No change since last year Yes No Are you engaged in any form of farming or ranching? Yes No Auto CoveragesHave 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). No change since last year Yes No Do you own any minibikes, mopeds or motorcycles that we do not insure? No change since last year Yes No Are any of your vehicles used for Uber, Lyft, Taxi or Delivery? Yes No Do we insure all vehicles in your household? Yes No Are your automobiles titled to a Trust, LLC or to anyone other than yourself? No change since last year Yes No Are your automobiles registered in the state where we have them insured? Yes No Are all the licensed drivers in your household listed on your automobile policy? No change since last year Yes No Do you have any vehicles furnished for your regular use that you do not own, such as a company car? No change since last year Yes No Do any of your vehicles have customized equipment? No change since last year Yes No Additional CoveragesWould you like to add or increase Umbrella or excess liability coverage? Yes No Would you be interested in discussing or adding earthquake or flood coverage to your policy? 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? Yes No Can we help you with any life insurance needs? Yes No Anything else you would like us to know?
