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Home » Client Center » Commercial Insurance Annual Questionnaire

Commercial Insurance Annual Questionnaire

Please complete this commercial business renewal form.

Review and submit the Commercial Insurance Annual Questionnaire provided below.

Home » Client Center » Commercial Insurance Annual Questionnaire

Please take a moment to complete our Commercial Insurance Annual Questionnaire to ensure your coverage remains up to date.

Commercial Insurance Annual Questionnaire

It’s important to review your coverage to ensure it remains up to date.

"*" indicates required fields

Step 1 of 5

20%

This field is for validation purposes and should be left unchanged.

This field is for validation purposes and should be left unchanged.

Contact Information

Named Insured*

Named Insured

First Name* Last Name*

Email Address*

Email Address*

Completed By*

Completed By

First Name* Last Name*

Is the Named Insured shown correct?*

Yes

No

Business Entity and Operations Changes

Are there any new corporations, partnerships, limited partnerships, or joint ventures?*

Yes

No

Has your company started, acquired, sold, or discontinued any operations during the past year?*

Yes

No

Has your company had any building or location changes during the past year?*

Yes

No

Number of Employees*

Number of Employees*

Annual Payroll*

Annual Payroll*

Annual Revenue*

Annual Revenue*

Please always notify us of any changes as soon as possible.

Property Coverage

Builder’s Risk Included: Occupancy Can Delete Coverage

Do you own the building?*

Yes

No

If the building is not insured with us, do you have building coverage elsewhere?*

Yes

No

Not Applicable

Do you have any of the following items?

Fences

Signs

Antennas

Awnings

Glass

Carports

Do you feel your insurance amounts on your building and personal property are sufficient?

Yes

No

Do you need coverage on personal property of others?

Yes

No

If yes, what limit would you like?

If yes, what limit would you like?

If you are a tenant, have you made improvements to the area you lease?*

Yes

No

Not Applicable

Have you purchased, leased, or acquired any real property or locations, including vacant land, during the past year?*

Yes

No

If you have computer coverage, is your limit adequate?*

Yes

No

Not Sure

Not Applicable

Are there any changes not already endorsed to the following business-owned items?

Automobiles

Trucks

Boats / Yachts

Aircraft

Mobile Equipment & Tools

Please describe any changes to the business-owned items selected above.

Please describe any changes to the business-owned items selected above.

Liability Coverage

Annual Sales*

Annual Sales*

Annual Payroll*

Annual Payroll*

Are you interested in higher limits of liability, if available?*

Yes

No

Maybe

Are you required to carry liquor liability coverage?*

Yes

No

Not Sure

Have there been any changes in operations during the past year?*

Yes

No

Do employees use their own cars on company business?*

Yes

No

Do you or any of your employees, family members, or officers use any company vehicle for ridesharing services such as Uber or Lyft?*

Yes

No

If you answered yes to the ridesharing question above and have not discussed coverage for this exposure with your producer or account manager, please contact our office as soon as possible.

Workers Compensation Coverage

If you do not have workers’ compensation coverage with us, do you have coverage elsewhere?*

Yes

No

Not Applicable

Do you have remote workers in other states?*

Yes

No

Are you working in states other than your domiciled state?*

Yes

No

Miscellaneous Coverage Options

Are you interested in crime coverage, such as employee dishonesty, or in changing your current crime coverage?*

Yes

No

Maybe

Are you interested in discussing protection for allegations of discrimination, harassment, or similar claims against your company?*

Yes

No

Maybe

Would you like to discuss any of the following property coverages?

Earthquake

Flood

Would you be interested in a life or health insurance quote?*

Yes

No

Would you be interested in a personal home or auto quote?*

Yes

No

Do you currently own and use drones in the operations of your business?*

Yes

No

If you answered yes to the drone question above and have not discussed coverage for this exposure with your producer or account manager, please contact our office as soon as possible.

Final Review

Upload supporting documents (optional)

Drop files here or

Accepted file types: pdf, doc, docx, jpg, png, Max. file size: 300 MB.

Consent*

I agree to the privacy policy.

By submitting your mobile number, you agree to receive periodic text messages from us. Standard messaging rates may apply.

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Commercial Insurance Annual Questionnaire - Filling Out Documents for Commercial Insurance in Office

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About
Business
Personal
Life
- Individual Life Insurance
- Child Life Insurance
Locations
- Erlanger, KY
- Cincinnati, OH
Client Center
Get a Quote

Dave Ramsey ELP
Resources
- Blog
Call 859-727-6675 in KY
Call in OH

Visit Gartman Insurance Agency on Twitter
Visit Gartman Insurance Agency on Facebook
Visit Gartman Insurance Agency on Linkedin
Visit Gartman Insurance Agency on Instagram

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