Hi <<PP_First>>


Your <<Input:What type of policy?>>, policy number <<Pol_PolNum>>, is set to renew. We have been busy reviewing your policy coverage, discounts and premiums. Please take a moment to review and return this two page survey and advise us if you have any questions or changes.


Have you had any changes in your business?




Number of Employees



Hiring Practices


Structure Change

LLC, Inc.

If you answered "no" to any changes in the past year, please mark here_________.


If you answered "yes" to any of the above please explain how your business has changed._______________________________________________________________________________________________________________________________________________________________________________________________________________

Do I have this coverage?


Common Optional Coverages




Directors and Officers-

Protect individuals from personal losses if they are sued as a result of serving as a director or an officer of a business or other type of organization


Abuse and Molestation -

Offers organizations broad protection against allegations of abuse or molestation brought by clients


Employers Practices Liability-

Protects businesses from claims by workers that their legal rights have been violated including but not limited to; sexual harassment, discrimination, and wrongful termination.


Cyber Liability-

Third party cyber liability, first party


Umbrella -

Policy designed to provide protection against catastrophic losses. It generally is written over various primary liability policies, such as the business auto policy (BAP), commercial general liability (CGL) policy, and employers liability coverage ...


Business Income-

Covers loss of income that a business suffers after a disaster


Employee Benefits Liability-

Covers damages that arise from a mistake or error affecting an employee’s benefit program


Special Event-

Coverage for special events, hole-in one , including host liquor liability


Group Life Insurance-

Employer-sponsored group policy which covers you for as long as you're working for the employer. The coverage ends when you leave the company


Group Health Insurance-

Coverage that pays for medical and surgical expenses incurred by the insured


Hired and Non-Owned Auto-

Liability insurance covers bodily injury and property damage caused by a vehicle you hire (including rented or borrowed vehicles) or caused by non-owned vehicles (vehicles owned by others, including vehicles owned by your employees).


If you have any questions or amendments about your coverage, please do not hesitate to contact us at <<Agncy_Phone>> or <<Agncy_Email>>.


We are looking forward to hearing from you.


<<User Name>>
<<User_Notes>>, <<Agncy_Name>>
<<Agncy_Address>>, <<Agncy_City>>, <<Agncy_State>>  <<Agncy_Zip>>
Phone:<<Agncy_Phone>>  |  Fax: <<Agncy_Fax>>