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Commercial Insurance
Personal Insurance
Co-op Insurance
About Us
Our Team
Blog
Contact Us
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BOP, GL, & Package Renewal Form
BOP, GL & Package Renewal Form
Business Name
*
Email
*
Mobile Phone Number
*
First Name
*
Last Name
*
Gross sales
*
Gross employees payroll
*
Gross owner/officer payroll
*
Is your business still operating under the same legal entity?
Yes
No
Please explain any changes to your legal entity
Have you moved to a new location or opened any other locations?
Yes
No
Please explain any changes to your location(s)
Have you lost or hired new employees?
Yes
No
Please indicate all employee and payroll changes
Have you changed any of the services that you are offering?
Yes
No
Please explain any changes to the services you are offering
Are you offering any new products?
Yes
No
Please explain any new products
Are you leasing any equipment that needs to be covered by this policy?
Yes
No
Please provide details for any equipment that needs to be covered
If it's not your home, do you own the building your business occupies?
Yes
No
Have you purchased or sold any Business Personal Property in the last year over $1,500?
Yes
No
Please provide details of any purchased or sold Business Personal Property
Have you added or sold any company autos in the past year?
Yes
No
Please provide details of any company autos that were added or sold
Would you like to receive information or a quote on Cyber Liability Insurance?
Yes
No
Would you like to receive information or a quote on Employment Practices Liability Insurance?
Yes
No
Additional comments or questions
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