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Home > Business Insurance Review Questionnaire Form

Business Insurance Review Questionnaire Form

NOTE: Please do not click the back button on your browser as your information will be deleted, and will have to be re-entered.
Do NOT HIT ENTER at ANY TIME or you will close this form. You MUST TAB or CLICK on each Yes or No answer. To type answers, click inside EACH BOX and fill in the information. Once you have completed the form, click submit.
Business Name:
Do you wish to make, or do circumstances require any changes to your current liability limits or coverage amounts?
- Yes
- No
Have you made any improvements or renovations to your buildings or added any structures since you last reviewed the coverage amounts on your policy?
- Yes
- No
Does your building/premises have:
- Smoke Detectors
- Dead Bolt Locks
- Fire Extinguishers
- Alarm System
Have you added, changed, or deleted any security systems, safes, or sprinkler system?
- Yes
- No
Any changes or additional equipment, signs, computer equipment, tools purchased?
- Yes
- No
Has there been any change in your business; such as:
- New products sold or services provided?
- Changes to existing products or services offered?
- Changes in operations or types of work performed?
Are you regularly in possession of other people’s property? (i.e., for repair or maintenance)
- Yes
- No
Do you or any employee carry company money off site?
- Yes
- No
Are all owned or leased vehicles listed on your policy?
- Yes
- No
Do you work, maintain or operate a business, or keep samples for your business at any other location not listed on your policy?
- Yes
- No
Would you like information on wind mitigation credits?
- Yes
- No
Your property coverage may not provide coverage for ordinance or law. Do you want a quote for this very valuable coverage?
- Yes
- No
If you do not have a workers’ compensation policy, would you like a quote?
- Yes
- No
Would you be interested in a quote for Employment Practices Liability Insurance? (Wrongful Termination, Discrimination, Sexual Harassment, etc.)
- Yes
- No
Have there been any changes in:
- Payroll
- Sales Receipts
- Space Occupied
Do you own any additional property, vacant land, or rent or sublet any portion of your building to others?
- Yes
- No
Does your office have any recreational facilities?
- Yes
- No
Do you obtain certificates of insurance from all subcontractors?
- Yes
- No
Your business policy DOES NOT provide flood insurance. Would you be interested in a flood insurance cost quotation?
- Yes
- No
Would you be interested in a quotation for Life, Retirement, Group Health or Disability insurance?
- Yes
- No
Please describe all your operations, products, or services:
Thank you for taking the time to complete this questionnaire.
Insured’s Signature
Date
Title
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Email Address

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The Turner Insurance Advisor Group specializes in Auto & Home Insurance, Business Insurance, Homeowners Association (HOA) & Community Association Insurance for all of Florida, including Clearwater, Tampa, St. Petersburg, New Port Richey, Spring Hill, Palm Harbor, Oldsmar, Tarpon Springs, Land O Lakes, and Dunedin.

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